This story was last updated at 4:50 p.m. on April 22.
Despite the ongoing pandemic and demand for medical resources, health care providers in Charlotte are seeing significant drops in revenue. In response, at least two are laying off workers. Others are borrowing millions to cover expenses.
Hospitals have suspended non-essential appointments and elective surgeries, both major sources of income. Health care providers have moved to virtual visits amid the local stay at home order, reducing the need for administrative staff present at offices.
One such provider is Tryon Medical Partners, an independent medical practice that spun off from Atrium Health in 2018. Earlier this month, Tryon laid off off about 75 employees, roughly a quarter of its 300-person staff, because of a decline in routine patient visits since the COVID-19 outbreak began.
The workers affected are both full and part-time, and include non-physician positions such as receptionists and nurses. Tryon says it notified those employees of the cuts in late March.
Typically, Tryon sees about 1,000 to 1,300 patients per day at its eight clinics throughout the region. But like other providers, Tryon has recently been doing many more virtual visits, which require fewer employees.
The number of patients coming in has shrunk dramatically in recent weeks, and as a result, Tryon is scaling way back.
“This has been a gut-wrenching decision for me, our physician-led board of directors and all our 92 doctors, who own our practice,” says Dr. Dale Owen, CEO of Tryon and a cardiologist with the practice.
Tryon has been reaching out to its patients to encourage those with existing check-ups to keep them. Sick patients visit one of the two coronavirus-dedicated clinics Tryon set up, not their regular physicians’ offices. And Tryon staffers wear masks and screen healthy patients coming in for visits like physicals.
Another health-care provider, Holston Medical Group, earlier this month dismissed 35 physicians who were already planning to leave the practice. In a filing with the state this week, HMG said as a result, and as a way to consolidate care during COVID-19, it has permanently closed 10 offices and laid off 163 support staffers for those locations.
Those 163 laid off do not include physician assistants or nurse practitioners, a spokeswoman said. They only include office staff.
“With urgent COVID-19 cases being admitted to hospitals and the ‘Stay at Home Order’ in place limiting check-ups and elective care, we have seen a dramatic reduction in physician office visits – significantly impacting our organization,” HMG said on its website.
On April 23, Atrium announced that 36 former HMG physicians are joining Atrium Health in newly-formed practices called One Health Family Medicine and One Health OB/GYN, with multiple locations throughout the Lake Norman and North Charlotte area.
Charlotte’s health care providers are not alone in their financial challenges.
Aside from the hospitality industry, the health care sector has seen the most job losses in the last month, shedding more than 61,000 jobs nationally, according to federal data.
The challenges could continue, too. By June, more than 780,000 workers in family medicine practices nationwide could either be laid off, see their hours reduced, or experience a pay cut, according to projections from HealthLandscape and the American Academy of Family Physicians.
Charlotte’s biggest hospital system is even reporting financial challenges stemming from its COVID-19 response efforts.
At a virtual board meeting earlier this month, Atrium Health approved a measure to borrow $750 million to finance operations amid the pandemic.
CEO Gene Woods said that pausing elective surgeries is critical as the hospital prepares for a surge in COVID-19 patients needing care. But, he told the board, pausing such services has “significant financial consequences.” That’s what the loan is for.
Atrium spokesman Chris Berger says that the hospital has not yet had any layoffs as a result of COVID-19, though.
Charlotte’s other major hospital system, Novant Health, says it anticipated a decline in revenue when it canceled elective surgeries and non-essential appointments.
Novant is preparing for the long-term financial changes it may have to make to handle COVID-19, spokeswomen Megan Rivers says. For instance, the hospital is securing financing in case it need more funds to cover growing expenses.
“While we have not announced any changes like furloughs or alterations in any benefit plans, we are carefully monitoring our financial position,” spokeswoman Megan Rivers said in an email.
“It is possible that in the future we will make difficult decisions, but we are not there today.”
What’s less clear is how Charlotte’s hospital systems will staff the 3,000-bed field hospital they are planning to handle the surge in coronavirus patients, if they are watching expenses closely.
What’s also unclear is the potential effect on patients once the stay at home order lifts, and once patients start returning to the doctor normally. The loss of key administrative staff could cause long waits, for instance.