AAP Voices

Dr. Shana Egge’s pediatric health center doesn’t restrict how many poor patients with Medicaid coverage it takes. There are only two others like it in Spartanburg, S.C.

The practice has never made money, but its health system owner could afford to cover the losses until COVID-19 hit, Egge said.

The health system recently informed the team — Egge and another physician and two nurse practitioners — that it would close the center July 18.

“This is bad for me, but I also feel really bad for my patients,” Egge said. “I don’t have any idea where they’re going to be able to go.” More than 70% of the clinic’s patients come from low-income families receiving Medicaid.

Pediatricians across America are seeing steep drop-offs in business as parents, fearful of the virus, stay away.

But efforts to shore up the nation’s primary-care network have been wanting, particularly for smaller providers and those that serve the poor and young.

As the Los Angeles Times reported in a late April story that quoted Egge, the Department of Health and Human Services initially allocated emergency assistance for medical providers based on their Medicare revenues, which favored hospitals and physicians that care for a lot of elderly patients.

On a second round, the department allotted the aid based on providers’ total revenues, and that approach tipped the scales even more toward hospitals and providers that care for people with commercial health insurance, which typically pays much higher rates than Medicare or Medicaid, the Los Angeles Times pointed out.

Egge said the center where she works opened 5½ years ago to address an acute need: “Medicaid families simply couldn’t get in anywhere.”

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