COVID-19 plans shrink health care work for Minnesota clinics and hospitals

As the COVID-19 pandemic is spotlighting the acute need for health care workers, a shutdown in elective procedures has dried up work at health systems and private medical groups across Minnesota.

An order from Gov. Tim Walz indefinitely postponed all nonessential or elective surgeries and procedures starting in March in order to conserve needed supplies.

As a result, health systems across the state have implemented unpaid leaves and reduced hours for workers not directly involved with the pandemic response, where an expected surge of patients hasn't yet arrived. Two private medical groups tell the Star Tribune they have furloughed more than half their workers; some outpatient care centers are closing temporarily.

"This is an important substory behind the COVID-19 crisis," said Dr. Rahul Koranne, president of the Minnesota Hospital Association.

"The first story, and the most important story, is that these health care systems are caregivers, and so the focus is to prepare," Koranne said. But, he added, "some of our health care systems are calling it a significant bleeding that's happening right now."

Hospitals and doctors supported the order by Walz as a way to help the state prepare for the expected surge of COVID-19 patients, particularly as supplies like personal protective equipment for workers remain in short supply. Even so, it's driving significant changes for many who work in health care.

Fairview Health Services, which is one of the state's largest health care providers, said it expects to reduce some staff work hours beginning Monday. The Mayo Clinic is reducing or temporarily suspending hours or projects for supplemental or contract workers. Duluth-based Essentia Health has placed 500 nonmedical employees on unpaid leave.

Allina Health System hasn't resorted to those steps, but the Minneapolis-based nonprofit announced Thursday that it will continue to ask many workers to stay home while receiving regular pay. Allina employs about 29,000 people and is currently placing about 1,500 people per day on a status known as "low-need."

"It's what happens when there isn't work for staff to do and they aren't working," said Christine Moore, the chief human resources officer at Allina. "For the period of time now ... we are guaranteeing full pay if someone is in a low-need situation," Moore said, although it's unclear what happens after April 12.

Hospitals in the Twin Cities metro typically have a patient census that's between 75% and 90% of capacity, Allina officials said. Right now, the census across Allina's 11 hospitals is more like 40%, said Ric Magnuson, the chief financial officer.

Surgical volumes at Allina are about 10% to 20% of normal, Magnuson said, adding that the vast majority of the reduction is in outpatient surgery.

The health system is using this time to retrain some workers so they can care for the expected surge in COVID-19 patients, said Lisa Shannon, the chief operating officer at Allina. Since so much primary care is being provided via phone or online video, Allina is considering temporary closures for some smaller clinic locations.

With the cut in elective procedures, the Star Tribune reported last week, more than 10,000 Minnesota health care workers had applied for unemployment assistance over a 10-day period. But those numbers don't include the roughly 700 workers that were notified last Friday of furloughs at Summit Orthopedics, said Adam Berry, chief executive of the Woodbury-based specialty group. Summit Orthopedics normally operates 30 locations, and is now down to caring for patients at just four sites, Berry said.

"It's the right thing to do for the community and for the response to this crisis," he said. "But at the same time you have a great number of employees who are negatively impacted."

At Twin Cities Orthopedics, nine urgent-care centers have been consolidated to three, said Troy Simonson, the chief executive at the medical group. The specialty group is part of a larger collection of private practices called Infinite Health Collaborative, a 2,000-employee organization that's not currently using anywhere near its full supply of 40 locations.

"We're definitely furloughing staff and, as you can imagine, it grows essentially by the day," Simonson said. "It's surreal. … It's crazy conversations that we're having right now."

At Nura P.A., a pain clinic based in Edina, more than half of about 150 workers at the medical practice are on furlough, said Dr. David Schultz, the practice's chief executive. During a typical week before the crisis, he said, the medical group would probably perform about 100 interventional pain procedures per week.

"All of a sudden, that goes to essentially zero," Schultz said.

In western Wisconsin, Hudson Physicians has seen the volume of primary care patients drop by about 40%, prompting the medical group to ask if some workers can stay home at times, said Matt Brandt, the chief executive of the medical group.

"We're preparing for a pandemic, and yet we're all cutting down to skeleton crews," he said. "We're not laying people off, because we expect we will get busy."

The financial pain for private practices and health care systems is real, said Allan Baumgarten, an independent health care analyst in St. Louis Park. What's unknown is how long it lasts.

"Every time you have an empty book of appointments for endoscopy or colonoscopy or knee replacements, that's revenue lost that you really don't get back," Baumgarten said. "I would think that for some of these specialty practices that are very closely linked to a volume of elective procedures, I think it gets difficult and scary even very quickly."

Christopher Snowbeck • 612-673-4744

Twitter: @chrissnowbeck