On March 3, Susan Coker, the practice administrator of Tri County Internal Medicine in suburban Atlanta, and Kelly Stopek, the practice’s medical director, left for a vacation in Costa Rica. When they returned a week later, Coker recalls, “the world had changed.” COVID-19 had arrived.

“Since March 10, we’ve spent 90% of our time on COVID-19 in some form,” Coker says, adding that the practice began seeing a “dramatic decrease” inpatient visits following President Donald Trump’s national emergency declaration a few days later. Through the end of April, patient visits were 50% to 60% of what they’d been pre-pandemic, and the practice’s revenues were poised to take a similar hit. “If your charges aren’t coming in, then the payments won’t be there either,” she says.