According to informal survey results from the American Medical Association, the ongoing impact of the February 21 Change Healthcare cyberattack and subsequent system outage threatens the sustainability of physician practices across the country, which could lead to closures, destabilizing patient care in some areas.
The practices of 10 or fewer physicians – the majority of the 1,400 survey respondents, or 78% – appeared to be particularly hard hit, the AMA said in a statement last week, also noted that, despite the challenges, practices showed resilience, with only 15% indicating that their practices had reduced hours since the disruption began.
However, the AMA is concerned that many will not survive much longer and highlighted the severe impacts on patient care that respondents reported in the survey.
WHY IS IT IMPORTANT?
The ALPHV ransomware attack believed to have targeted Change Healthcare first impacted pharmacies and access to drug treatments across the country, but it didn’t take long for care organizations to health and feeling financially stressed.
With the revenue cycle destroyed by Change’s elimination, most practices for which state medical associations and national medical specialty associations contact the AMA on behalf of the AMA between March 26 to April 3, all experienced service disruptions – in fact, 77% of them were disrupted.
More revenue was lost from unpaid claims – 80% – and even more employees committed additional time and resources to what respondents said was a significant use of settlements. Alternative method – 85%.
The survey comes after UnitedHealth Group said the claims process would resume the weekend of March 23, the AMA said. According to UHG’s Change Healthcare online feedback update page, although some Change complaints handling systems have been restored, many services are only partially operational, while many others are still in use. use.
The findings show that high levels of disruption have led to serious consequences for physician practices.
“The survey is also a reminder of the fragility of the medical practice,” the organization said. It noted that claims settlement and other financial impacts persist, despite new arrangements with alternative clearinghouses, because the event is costly to operations. small cave.
“We can’t afford the cost of doing this.” one respondent told the AMA. “Other clearinghouses are taking advantage of this and small operations like mine who are struggling with no money coming in can’t afford to pay three times as much to take the time to convert clearinghouses.”
Another respondent broke down the numbers to figure it out:
“About $10,000 just to set up a backup clearing house,” they said. “In addition, one of our payers changed clearinghouses and they told us we would charge an additional 2% fee on all claims, which will cost the organization approximately $1,000,000.”
Physician practices reported receiving upfront payments, interim funding assistance and loans, including from the Centers for Medicare & Medicaid Services – 12% – UnitedHealth Group/Optum – 25% – other health plans and state Medicaid programs – 4.5% and 0.7%, respectively. .
Most worryingly, respondents said, patient care was also affected, with the AMA highlighting risks to patient access.
“Many respondents were concerned about the negative impact this attack would have on patient care,” the association said.
In addition to procedural delays, canceled appointments due to loss of access to insurance verification and inability to receive medications led to a “significant” flare-up in at least one patient’s illness, one respondent said. the disruption has “severely impacted our ability to manage pain care.” with our cancer patients.”
BIGGER TREND
While more efforts are needed to avoid cyberattack chain reactions like those that followed the Change Healthcare cyberattack, the American Hospital Association recently shared concerns with the Subcommittee on Health of the House Energy and Commerce Committee that imposing fines or cutting Medicare payments “would be unfair.” penalizes hospitals and fails to improve the cybersecurity of the entire healthcare industry.”
The AHA told lawmakers Wednesday at a hearing on the Department of Health and Human Services’ FY 2025 Budget that imposing potential penalties on hospitals and Other healthcare options can reduce the organization’s resources needed for cyber defense.
“The cybersecurity proposal included in the President’s FY 2025 budget to punish hospitals is misguided and will not improve overall cybersecurity,” the AHA said in its testimony. of the healthcare industry”.
ON PROFILE
AMA President Dr. Jesse M. Ehrenfeld said in a statement: “These survey data clearly show that clinics will close as a result of this incident and patients will lose access to contact their doctor”. “The one-two punch of cumulative Medicare cuts and the inability to process claims resulting from this attack is devastating to physician practices already struggling to stay afloat. hold their doors.”
Andrea Fox is a senior editor at Healthcare IT News.
Email: [email protected]
Healthcare IT News is a publication of HIMSS Media.
