COVID-19's Financial Impact on Primary Care Clinicians and Practices

Melissa K. Filippi, PhD, MPH; Elisabeth Callen, PhD; GStat, Ann Wade, BS, BJ; Megan Coffman; John M. Westfall, MD; Yalda Jabbarpour, MD; Christina M. Hester, PhD, MPH; Jennifer Carroll, MD, MPH


J Am Board Fam Med. 2021;34(3):489-497. 

In This Article

Abstract and Introduction


Introduction: Coronavirus disease 2019 (COVID-19) disrupted and undermined primary care delivery. The goal of this study was to examine the financial impacts the pandemic has had on primary care clinicians and practices.

Methods: The American Academy of Family Physicians National Research Network and the Robert Graham Center distributed weekly surveys from March 27, 2020, through June 15, 2020, to a network of more than 1960 physicians. Responses to the question, "Could you please tell us about any financial impact the COVID-19 pandemic has had on your practice, if any?" were analyzed using a grounded theory approach of qualitative analysis. The number of unique respondents who answered the financial impact question totaled 461 over the 12 weeks.

Results: Severe declines in patient visits, causing drastic revenue reductions, greatly impacted the ability to serve patients. Primary care clinicians and practices experienced significant changes in several areas about financial implications: patient visits, financial strain, staffing and telehealth.

Discussion: Preliminary findings revealed that even with Coronavirus Aid, Relief, and Economic Security Act, also known as CARES Act, funding, business viability remains questionable for some primary care practices.

Conclusions: Low patient visits directly resulted in decreased revenues, which in turn, impacted staffing decisions and fueled telehealth implementation. It is difficult to predict whether patient visits will increase after June. Alternate payment models could provide some financial stability and address business viability.


COVID-19's unprecedented economic impact on the global scale[1,2] and within the United States[3–5] has been profound. Models have predicted that the financial impact of COVID-19 on primary care practices could result in devastating increases in primary care shortage areas as practices are forced to close.[6] This is particularly troublesome as primary care is the first line of defense for patient care in the US health care system. Our objective was to examine the financial impact the COVID-19 pandemic has had on primary care clinicians and their practices.