Healthcare News of Note: 54% of patients do not care whether they see a corporate or independent primary care provider, but more prefer independent practices, survey says

• In the study conducted in July of 1,000 U.S. of patients who had visited a healthcare provider within the past two years, survey results show 38% prefer independent practices and 8% favor corporate practices.
• The cost for the off-label use of the drug semaglutide — such as Ozempic and Rybelsus — is typically much lower in other large, wealthy countries than in the United States.
• Three national healthcare organizations called for systemic changes, more resources and a focus on inequities to more effectively treat the nearly 500,000 children and youth with pediatric mental and behavioral health issues being seen each year in U.S. emergency departments.

Over the past few weeks, I have found these industry news stories that should be of interest to healthcare finance professionals.

1. 38% of survey respondents prefer seeing an independent practice provider while 8% prefer corporate providers

Although more than half of patients (54%) “have no preference between an independently owned or a corporate medical provider,” there’s good news for independent practices, according to an Aug. 22 news release sharing results of a new survey* by Software Advice.

1. In the study of 1,000 U.S. patients conducted in July, survey results show:

• 38% prefer independent practices
• 8% favor corporate practices

2. When study participants were asked, “How satisfied they were with their last medical exam, the patients who last saw independent primary care providers were the happiest, with 60% saying they were ‘extremely satisfied’ and 36% being ‘somewhat satisfied.’”

Lisa Morris, associate principal healthcare analyst at Software Advice, said in the release, “With the shrinking number of primary care providers and independently owned healthcare practices, those remaining have to fight to stay afloat, and doing so relies on understanding exactly what these large healthcare organizations are offering that they aren’t.”

Corporate practice benefits

“Among patients who last visited a walk-in clinic at a pharmacy or an urgent care practice, speed and low cost of care were the top benefits of visiting these types of providers,” wrote the study authors. Among corporate medical practice fans, “speed” was the top benefit, with:

• 66% saying they can schedule appointments faster
• 51% indicating doctors respond faster
• 42% noting exams are faster

Independent practice benefits

“Fortunately, the benefits identified by patients who last visited an independent primary care provider are more substantive than the benefits of those who last saw a doctor at a corporate healthcare practice,” wrote the authors. “Patients spoke to the higher quality of care and the more personal relationships with these providers, instead of merely highlighting convenience and speed of exams.”

Responses from those with a preference for independently owned practices, included:

• 78% say they have a more personal relationship with these providers
• 60% say they trust them more
• 57% say the quality of care is higher (only 26% who said this is true for walk-in clinics and only 19% for urgent care facilities)

* Software Advice’s 2023 Independent Practice Survey was conducted in July 2023 among 1,000 patients in the U.S. who had visited a healthcare provider within the past two years.

2. How U.S. EDs can deal more efficiently with the ‘surging numbers’ of pediatric mental and behavioral emergencies

“Systemic changes, more resources and a focus on inequities” are required to help U.S. emergency departments (EDs) more effectively handle the surge in children and youth experiencing pediatric mental and behavioral health emergencies that come through their doors each year, according to three national healthcare organizations.

The American College of Emergency Physicians (ACEP) and Emergency Nurses Association (ENA) joined the American Academy of Pediatrics (AAP) in issuing this appeal and an updated policy statement, according to an Aug. 16 news release.

“The nation’s emergency departments are the first, and sometimes the only point of care for surging numbers of young patients with mental health emergencies,” stated the release.

Some recommendations for EDs

Several tactics to help EDs better handle the influx of young people needing such care were noted in the release and include:

• Engaging with the community to develop suitable ED transfer strategies, including appropriate referrals to psychiatric crisis units, within psychiatric facilities or community mental health centers.
• Developing mental health mobile crisis teams that can respond to schools, physicians’ offices and homes.
• Addressing inequities by increasing screening, identification, treatment and referrals of ED patients for mental and behavioral health symptoms.

The organizations agree that EDs “would benefit by providing a dedicated multidisciplinary approach to provide patients with trauma-informed services,” states the release.

In the release, Mohsen Saidinejad, MD, MS, MBA, a lead author of the policy statement and member of the AAP and ACEP committees on Pediatric Emergency Medicine, states: “The time has come to address the mental health crisis of our youth. … Children and families deserve timely, affordable, and equitable access to care and treatment, just as they would if they present with a broken arm, a seizure or a serious infection.”

Saidinejad also noted that due to a “lack sufficient personnel, capacity, and infrastructure to triage and treat patients with mental and behavioral emergencies,” ED patients often face lengthy wait times.

HFMA resources

HFMA has additional content addressing pediatric mental health issues, including:

A March 29 article “Reports on patient safety indicate progress, challenges and a need to focus on pediatric mental health,” by Nick Hut, senior editor.

The Jan. 13 Healthcare News of Note blog: “How to prevent pediatric mental health revisits.”

3. The cost of off-label weight loss drugs in the U.S. can be four and five times more than what patients in peer countries are charged

List prices of drugs to treat diabetes that are increasingly used for weight loss in the U.S. and peer nations are higher in the U.S., according to results of a Peterson-KFF Health System Tracker review published Aug. 17.

The Peterson-KFF analysis of the off-label use of the drug semaglutide — such as Ozempic and Rybelsus — “are typically much lower in other large, wealthy countries than found in the U.S.,” wrote the authors. For instance:

• The list price* for one month of Ozempic in the U.S. ($936) is over five times that in Japan ($169), and about ten times more than in Sweden ($96), the United Kingdom ($93), Australia ($87) and France ($83).
• A one-month supply of the oral tablet form of semaglutide, Rybelsus, is priced similarly to Ozempic at $936 in the U.S., which is over four times as much as the price in the Netherlands ($203).
• Other drugs such as Wegovy — available in only a few European Union markets at this point and Mounjaro — not yet recommended in the U.K. — were also analyzed and found to cost significantly more in the U.S.

Supply and demand and total impact on health spending

The study authors wrote, “What impact these drugs have on total health costs in a country will depend not just on the net prices for the drugs, but also on how many people use them. The U.S. has by far the highest rate of obesity among peer nations,” with 33.6% of the population being obese in the U.S. compared with an average of 17.1% across peer nations.

“High rates of obesity and potential market demand for the weight-loss drugs could result in a significantly higher impact on total health spending in the U.S. than in peer nations,” considering results from another recent KFF poll show:

• 45% of adults in the U.S. would be interested in taking prescription weight-loss drugs.
• Interest in these same drugs dropped to 16% if they are not covered by insurance or after learning weight gain could occur after stopping use (14%).

* Prices listed were available through website searches for four weekly shots or a 30-day supply of maintenance dosage in the U.S. and other large, high-income countries.

HFMA resources

HFMA provides regular content on drug costs, including:

• “Dr. Ronald Hirsch of R1 RCM discusses new Alzheimer’s drug Leqembi with HFMA’s Nick Hut” in the Aug. 2 episode of HFMA’s “Voices in Healthcare Finance” podcast.
• The Aug. 11 News of Note blog: “10 drugs account for a large share of Medicare Part D spending.”

HFMA bonus content

Read the September issue of hfm magazine, including the cover story, “Value-based care: A crisis of faith?,” by Paul Barr, MBA, MS, senior editor, and the column “It’s time to be biased toward action,” by HFMA National Chair Dennis E. Dahlen, FHFMA, MBA, CPA.

Listen to one of the latest Voices in Healthcare Finance podcast episodes, “Fighting for systemic change by putting the patient first,” with host Erika Grotto, senior editor.

Read the article “Data indicate hospital operational logjams haven’t ceased after the public health emergency” by Nick Hut, senior editor.

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