The last several weeks have seen a radical transformation in the delivery of health care in the United States. Physicians have moved millions of in-person office visits to video or telephone. Clinical teams have managed patients with serious illnesses without hospitalization whenever possible. Hospitals have shifted infusion therapy and other services to the home setting.
This abrupt shift, driven by the coronavirus disease 2019 (COVID-19) pandemic, has led to a tremendous loss of revenue. In the US, the predominant mechanism for paying clinicians, hospitals, and other facilities for health care is the fee-for-service model. It is estimated that physicians have lost about 55% of revenue and hospitals are experiencing negative operating margins, significantly affecting cash flow and leading to layoffs and the threat of closure.
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