Impact of the Change Healthcare Disruption

1. Contact Information

2. To what degree have your services been impacted? Which disruptions have been most harmful to you, your practice, and your patients?

3. What national and local payers have reached out to you to offer technical assistance or funding?

4. If you have applied for financial assistance, how easy/difficult was the application process?

5. If you received funding, how meaningful is the funding?

6. What are the patient impacts, if any?

7. Please describe specific examples of the impacts on lost revenue, up to and including staff layoffs, closures, etc., you are comfortable sharing.

8. May we use your responses in AAFP communications to decision makers?