Twitter Chat Wrap-Up: How Pathologists Can Navigate COVID-19-Related Practice Management Challenges

01/01/1970

Brian H. Le, MD, MBA, FCAP

Article

On May 12, 9pm EST, I took over the @Pathologists Twitter handle to host a discussion about the resources available to pathologists as we navigate the practice management-related challenges resulting from the impact of COVID-19.

I also participated as a panelist under my Twitter handle (@brianhlemd), and was joined by CGPA Chair Jonathan Myles, MD, FCAP (@JonathanMyles10).The CAP’s Advocacy office (@capdcadvocacy) participated to address any regulatory issues.

Below are some highlights from the hour-long discussion. Also, be sure to scroll to the bottom of this blog to view additional resources related to COVID-19.

Key Challenges Faced By Members

@JonathanMyles10: As CGPA Chair, what are you hearing from members, in terms of key challenges right now? #capchat

— CAPathologists (@Pathologists) May 13, 2020

Most practices are under financial distress, We want to share what programs are out there to assist. #capchat

— Jonathan Myles (@JonathanMyles10) May 13, 2020

The Paycheck Protection Program from the Cares Act can help some practices who are financially impacted. #capchat

— Jonathan Myles (@JonathanMyles10) May 13, 2020

The labs have excess capacity at present but reagents are the limiting factor. #capchat

— Jonathan Myles (@JonathanMyles10) May 13, 2020

We know from our survey that there are supply issues with reagents.#capchat

— Jonathan Myles (@JonathanMyles10) May 13, 2020

Thank you Dr. Myles. The results of our COVID-19 impact survey of CAP-accredited laboratories are available: https://t.co/2DObpahbvu. #capchat

— CAP Advocacy (@CAPDCAdvocacy) May 13, 2020

However, with the partial re-opening in some parts of the country I hear that some areas are beginning to increase volume but not back to where it was by any means.#capchat

— Jonathan Myles (@JonathanMyles10) May 13, 2020

#CApchat I agree. In my area, recovery is expected in May to Sept and expansion after September. But without vaccination and effective therapy, I am not sure we will be able to recover to the normal before COVID-19 pandemic. https://t.co/c5rkqMpUZS

— Dr. Bui Pathologist (@DrBuiPathology) May 13, 2020

Dr. Bui I agree that there will changes in our business for a long time.#capchat

— Jonathan Myles (@JonathanMyles10) May 13, 2020

#capchat @Pathologists Do we know what percentage of pathology laboratories are in financial trouble and what are the most practice types?

— Dr. Bui Pathologist (@DrBuiPathology) May 13, 2020

Most labs report financial distress but it varies from lab to lab. I have heard that some labs are down 75%. Most numbers I hear are around 50-60%#capchat

— Jonathan Myles (@JonathanMyles10) May 13, 2020

Requirements to Qualify & Details on Federal Assistance Programs

Q2. What are the requirements to qualify for these programs? #capchat

— CAPathologists (@Pathologists) May 13, 2020

A2. Programs vary in their requirements. The Paycheck Protection Program is for small businesses with less than 500 employees #capchat

— Jonathan Myles (@JonathanMyles10) May 13, 2020

#capchat does CAP have programs to help pathology laboratories preparing applications to these programs? https://t.co/JH8oNSIkaP

— Dr. Bui Pathologist (@DrBuiPathology) May 13, 2020

The CAP website goes through the various programs with links to the various websites which describe the program. #capchat

— Jonathan Myles (@JonathanMyles10) May 13, 2020

A2. Also on the practice management page there are links to CAP calculators which can help you prepare for the numbers needed for applying for the Paycheck Protection Program.#capchat

— Jonathan Myles (@JonathanMyles10) May 13, 2020

Q3. How does a practice decide how much financial assistance to apply for? #capchat

— CAPathologists (@Pathologists) May 13, 2020

A3: The intent of the Paycheck Protection program is to assists businesses and practices to maintain payroll, utility, rent, mortgage interest expenses for 2.5 months #capchat

— CAPathologists (@Pathologists) May 13, 2020

What's been the typical lag time between application approval and disbursement of funds? #capchat https://t.co/QQ8Yam9Tg4

— Ric Mendoza (@RMendozaMD) May 13, 2020

It depends. Once an application is approved you may see funds in days. Typically it is a short process. The government wants to get the money in the hands to those that need it.#capchat

— Jonathan Myles (@JonathanMyles10) May 13, 2020

#capchat @Pathologists @JonathanMyles10 @DonKarcherMD Does CAP have a frequently asked questions and the answers to the government hospital assistant programs?

— Dr. Bui Pathologist (@DrBuiPathology) May 13, 2020

A2. Check out Today's Advocacy Update. There are recent updates to the relief programs with links to FAQ's.#capchat

— Jonathan Myles (@JonathanMyles10) May 13, 2020

That's right — just published today is the CAP’s CARES Act guide: https://t.co/FJexRELoPQ. #capchat

— CAP Advocacy (@CAPDCAdvocacy) May 13, 2020

Keep in mind that you will have to attest that you accept the conditions of receiving the funds. They are not to onerous but you must attest. Many details are in the links in todays' Advocacy Update newsletter.#capchat

— Jonathan Myles (@JonathanMyles10) May 13, 2020

A4: Financial assistance from these programs are meant to sustain the practices only during the COVID period. They must be used for payroll, business rent, business utilities and mortgage interest (not to pay off mortgage principles) during this time. #capchat

— CAPathologists (@Pathologists) May 13, 2020

#capchat @Pathologists does the laboratories apply to the paycheck protection program independently or as a part of the package of the hospital application? https://t.co/lQvD7j1FFu

— Dr. Bui Pathologist (@DrBuiPathology) May 13, 2020

Yes Dr Bui. The FAQ's are on the CAP website. Congrats to the CAP staff for updating it regularly.#capchat

— Jonathan Myles (@JonathanMyles10) May 13, 2020

If the laboratory is part of the hospital, then it is part of the hospital operations; likely, there would be more than 500 employees, and so the Paycheck Protection Program wouldn't apply.

— Brian Le (@brianhlemd) May 13, 2020

#capchat That makes sense. It seems that standalone smaller pathology laboratories which are typically less than 500 employees are qualified. https://t.co/Amrkmqs56X

— Dr. Bui Pathologist (@DrBuiPathology) May 13, 2020

Please review our guidance uploaded to the https://t.co/R137dJMOg7 today: https://t.co/FJexRELoPQ. #capchat

— CAP Advocacy (@CAPDCAdvocacy) May 13, 2020

The Paycheck Protection Program is not designed for hospitals. There are other means that support hospitals during the crisis. For example, there is an increase in the DRG of 20% for COVID-19 related illness.#capchat

— Jonathan Myles (@JonathanMyles10) May 13, 2020

Curious, once you have the PP allocation it is unclear what an employer has to spend it on (ie 100% to payroll?). #capchat

— David Terrano (@david_terrano) May 13, 2020

Are employees informed that if employer obtains it would seem best they were)? And does the amount depend on who is employed at time of application or within a time period prior? Thanks! #capchat

— David Terrano (@david_terrano) May 13, 2020

Applications are submitted by employers, and so it would be up to the employers to inform employees of their application status.

— Brian Le (@brianhlemd) May 13, 2020

There is also the Cares Act Provider Relief Fund where funds are directly sent to you. #capchat

— Jonathan Myles (@JonathanMyles10) May 13, 2020

The Provider Relief Funds are sent to the TIN not the NPI. If you choose to accept the funds you must attest that you accept the conditions or return the money.#capchat

— Jonathan Myles (@JonathanMyles10) May 13, 2020

Medicare Reimbursement Update

If Pathologists are Independent Contractors—Do They Qualify?

Digital Pathology & Remote Sign-Out

Closing Thoughts

For updated information on COVID-19, please visit CAP.org’s Latest on the Novel Coronavirus (COVID-19).

Brian H. Le, MD, MBA, FCAP is a community hospital-based pathologist in Reading, PA. He is certified in Anatomic & Clinical Pathology, as well as Neuropathology. A member of the Practice Management Committee and Digital Contents Committee of the CAP, he holds an MBA and is a Certified Professional Coder and Biller with interests in revenue cycle management. He can be found on Twitter: @brianhlemd.

Twitter Chat Wrap-Up: How Pathologists Can Navigate COVID-19-Related Practice Management Challenges

Authors

Brian H. Le, MD, MBA, FCAP

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