- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04587245
The Provider Insurance Revenue Study in Healthcare Providers in the United States of America
The Provider Insurance Revenue Study
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Since the beginning of the COVID-19 pandemic in March, 2020, Physicians and other medical Providers have taken devastating hits to their practice revenues. Most of the losses are due to doctors being forced to curtail elective procedures and office visits as Americans were ordered to stay home during the height of the national health emergency.
As Physicians were able to return to work in the early Summer, even if only partially, many had to adjust to the newer medical practice of telehealth, and the lower revenues that came with it. The Centers for Medicare & Medicaid Services (CMS) gave assurances to Physicians that Medicare would reimburse telehealth encounters at 100% of the office visit rate. But private Payers were under no such obligation. Across the country, Physicians are reporting that they're being reimbursed at about 70% of an office visit rate despite the fact that telehealth requires both resources and expertise to implement effectively, and each encounter takes up to twice as long as an office visit.
Adding to financial hardships, Physicians across the nation are reporting that legitimate insurance claims are being held up and denied by the insurance companies at a higher rate than ever, cutting off the cash that they need so desperately. As of June 1, only half of Physician practices say they have enough cash to stay open for another month.
In just 2 months in the spring of 2020, over 45 million Americans lost their jobs and for many, that also meant the loss of their employment-related health insurance. Despite shedding a massive number of members from their rolls, health insurance companies are actually predicting record profits for 2020. The pandemic it seems, is very good indeed for the health insurance business. Private investors and executives are taking huge dividends and bonuses out of the system just at a time when US healthcare needs a vast new investment of healthcare resources into the system. The good fortune of a few individuals and corporations comes at an as yet untold expense to American society.
The formula for insurance company success in a pandemic only happens one way. By keeping member premiums, delaying payments, and denying treatment authorizations, the large health insurance companies are taking advantage of the profound misfortunes of both doctors and patients during a national health emergency.
The COVID-19 pandemic will have adverse effects on the health of Americans that will be sprawling and long-felt. However, it is not for this study to decide whether private interests will always be antithetical to public interests when it comes to healthcare. That is a public debate that will continue to evolve as the profound weaknesses of the American way of distributing healthcare are magnified and exposed in a time of social upheaval.
The investigators do know that in order to get a handle on the major damage we see occurring in real-time- and to inform that debate, it is first necessary to measure it.
Study Type
Enrollment (Anticipated)
Contacts and Locations
Study Contact
- Name: Henry Broeska, PhD
- Phone Number: 949-332-9638
- Email: hbroeska0@saddleback.edu
Study Contact Backup
- Name: Charles Bronson, MBA
- Phone Number: 415-530-8742
- Email: chasbronoson@gmail.com
Study Locations
-
-
California
-
Irvine, California, United States, 92617
- Recruiting
- University of California Irvine Beall Applied Innovation
-
Contact:
- Henry Broeska
- Phone Number: 949-332-9638
- Email: hbroeska0@saddleback.edu
-
Contact:
- Charles Bronson
- Phone Number: 415-530-8742
- Email: chasbronson@gmail.com
-
Sub-Investigator:
- Sheridan Merrick, BA
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- ADULT
- OLDER_ADULT
- CHILD
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Healthcare Provider based anywhere in the United States who is eligible to submit claims to an insurance company on behalf of patients.
- To agree to participate in this study
Exclusion Criteria:
- Any condition that at the discretion of the principal investigator renders the subject ineligible to participate in this study.
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Physicians
Physician or healthcare Provider based anywhere in the United States who is eligible to submit claims to an insurance company on behalf of patients
|
Online questionnaire, financial statements (one month per quarter in 2020) submitted electronically, interview with professional accounting firm and review of data and exit Interview
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in monthly income of healthcare Providers from baseline to 6, 9 and 12 months after the beginning of the COVID-related events
Time Frame: 12 months
|
Change in monthly income of healthcare Providers from baseline to 6, 9 and 12 months after the beginning of the COVID-related events
|
12 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Differences in Accounts Receivable (AR) due to claim denials over 4 quarters: Differences in recoveries of AR.
Time Frame: 12 months
|
Differences in Accounts Receivable (AR) due to claim denials over 4 quarters: Differences in recoveries of AR.
|
12 months
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Henry Broeska, PhD, University of California Irvine Beall Applied Innovation
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ANTICIPATED)
Study Completion (ANTICIPATED)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ACTUAL)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- PIRStudy
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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