AMGA CMO Council: Clinical Staffing Approaches to COVID-19

AMGA COVID-19 Resources

Presentation Summary
March 24, 2020

This summary is based on a discussion via AMGA’s Chief Medical Officer listserv as of March 24, 2020. For more information about the CMO Council, please click here.

Question: How are you handling overstaffing? Furloughs? Requesting people take vacation? Incentive to take vacation? Other? Any ideas or strategies would be welcome.

Washington State Group

  • Staff Rotation. We are definitely overstaffed, but feel we will need to call upon them as we hit the surge. We need folks on board as we prep for the surge in one to two weeks. We are taking advantage of this by having groups of people rest while others work and then switch off. For now, they are being asked to be on call to come in as needed and doing in-basket work from home, triage from home, scheduling, outreach, etc.
  • Managing Inpatients. Our specialists are being asked to manage inpatient volumes (GI, heart and vascular, pulmonary). Pulmonary are being asked to help in critical care. We have redeployed folks to roles outside of their lanes—greeter, triage (large need here), scheduling (telephonic, video and in-house visits). We are not laying off anyone.
  • Provider Payment. A few of our local payers have instituted the parity provision that our insurance commissioner approved. Regency (one of the Blues) and Aetna are paying commensurate to the work that is being done as evidenced by documentation. We are guaranteeing our providers at 90% of previous year's production for the first six months

New York State Group

  • Outpatient Focus on Telehealth. We are working through these issues and expecting our surge to come soon. We are rapidly transitioning to high-risk outpatient care only with a focus on telehealth. We are working through the complicated issue of what to do with salaries and currently discussing with our board the right mix for employees, employed physicians, and physician owners.
  • Staff Redeployment. Most providers have seen a 50%+ decrease in visits already, with the exception of those working in our COVID-19 evaluation sites. We are redeploying staff to areas that need attention, with the expectation that they would be in new roles: Some new roles are employee health, greeters/screeners at entry to practice, phone team (we have a large increase in them), scheduling telehealth appointments, working at the outdoor evaluation sites.
  • New Inpatient Roles for Physicians. We have created a centralized team that is responsible for identifying physicians willing to take on new inpatient roles. We are getting requests from numerous hospitals (we are an independent physician practice), and we also have contracts to provide hospitalists at two hospitals. Our first volunteer was a sports medicine doctor! We've identified medical specialties who are most amenable to inpatient care. Our plan is to have hospitalists flex up to ICU, medical specialists with inpatient responsibilities to flex up to lower level general medical admissions, and volunteers to be plugged into hospitalist roles.