Number of in-person visits declined less than among vertically integrated practices, study reveals
Researchers from George Mason University and the National Bureau of Economic Research examined changes to in-person and remote visits for patients treated by primary care physicians in independent versus vertically integrated practices. The study included about 4,600 physicians in integrated practices and 32,316 in independent practices.
For their analysis the authors used claims data from FAIR Health, a comprehensive national database encompassing roughly 75% of the privately insured population in the United States. Patients were categorized based on chronic conditions including asthma, depression, hyperlipidemia, hypertension, multiple chronic conditions or no chronic conditions. The data covered the period from March 1, 2018, to June 30, 2021.
They found that during the pandemic’s first quarter physicians in integrated practices saw an 18.75% greater reduction in in-person visits from patients with no chronic conditions compared to doctors in independent practice. However, the difference had narrowed to 14% by the pandemic’s sixth quarter. A similar narrowing occurred among patients with other conditions.
On the other hand, physicians in integrated practices experienced a 7.6% increase in telehealth visits from patients with no chronic conditions during the first quarter compared to physicians in independent practice. Here too, the data showed the difference between independent and integrated practices diminishing over time.
The authors speculate that the greater drop in visits to integrated practices during the early months of the pandemic indicate that these practices were under less financial pressure to maintain patient volume than were independent practices.
In addition, they say, the fact that physicians in integrated practices were more apt to see patients via telehealth is “consistent with greater resources, faster adoption of health technology and differences in practice culture and geography.”
The study, “Volume of Care for Primary Care Physicians in Integrated vs Independent Practices Through the COVID-19 Pandemic” was published in JAMA Health Forum.