Patient care has been shifting from physician offices (POs) to hospital outpatient departments (HOPDs). This shift occurs when a hospital system acquires an independent physician practice and has implications for both the delivery of care and its cost. In 2004, approximately 94 percent of chemotherapy infusions were administered in POs, but by 2014, that percentage had dropped to 57 percent, with a corresponding shift toward HOPDs. In this Fast Fact, results from the Consumer Engagement in Health Care Survey are reviewed and present a new, changing trend.
Mo Only re in abo fo ut rma one tio -th n ird about of pla then EBRI/Gre participan enwald ts wereResearc willing h toCon pay sumer En more for h gag ealth care service ement in Health s to Care be perfo Survey can rmed be at th foeir p und referred online. facility. Figure 2 The 2023 Consumer Engagement in Health Care Survey is an online survey of 2,020 Americans ages 21-64 Percentage of Plan Participants Willing to Pay More for Health Care April 25, 2024, #500 with private health insurance coverage. It was fielded between October and December 2023. The survey is Service to Be Performed at Their Preferred Facility made possible with funding support from the following organizations: Blue Cross Blue Shield Association, Would you be willing to pay more for each service to be performed at your preferred facility? HealthEquity, Inspira Financial, Segal, TIAA, and Voya Financial. 40% Plan Participant Preferences for Site of Care 36% The Employee Benefit Research Institute is a private, nonpartisan, nonprofit research institute based in 35% 32% Washington, DC, that focuses on Lean health, Towa savings,rd retirement, Phys and ici econ an Offices omic security issues. EBRI does not lobby 30% and does not take policy positions. The work of EBRI is made possible by funding from its mem 29% bers and Care has b 30% een shifting from physician offices (POs) to hospital outpatient departments (HOPDs). This shift occurs sponsors, which include a broad range of public, private, for-profit and nonprofit organizations. For more when a hospital system acquires an independent physician practice and has implications for both the delivery of informa 25%tion go to www.ebri.org or connect with us on Twitter or LinkedIn. care and its cost. One example of the shift from POs to HOPDs is related to chemotherapy infusions. In 2004, approximately 94 percent of chemotherapy infusions were administered in POs, but by 2014, that percentage had Greenw 20%ald Research is a leading independent custom research firm and consulting partner to the health and dropped to 57 percent, with a corresponding shift toward HOPDs (Winn, Keating, Trogdon, Basch, and wealth industries that applies creative quantitative and qualitative methods to help companies stay competitive Dusetzina, 2018). and n 15 avig % ate industry change. Leveraging deep subject matter expertise and a consultative approach, Greenwald offers comprehensive services to answer strategic business questions. For more information, go to The Employee Benefit Research Institute (EBRI) and Greenwald Research Consumer Engagement in Health Care 10% www.greenwaldresearch.com Survey shows that plan participants generally preferred to receive certain health care services in POs over HOPDs, were not willing to pay more for services performed in their preferred facility, and were not likely to 5% References think that physicians tied to a hospital system were better quality physicians or that higher costs were an indicator of higher quality. 0% Win n, Aaron N., Nancy L. Keating, Justin G. Trogdon, Ethan M. Basch, and Stacie B. Dusetzina. 2018. MRI Imaging Specialty Medication Distribution Lab Services Non-MRI Imaging When it "comes Spend to ing b preferred y Comme facilities, h rcial Insurers o ealth pn lan Chemoth enrollees we erapy Based o re split between HOPDs n Site of Care." JAMA Onco and POs for lo MRIs an gy, E-1,d E -2. Source: EBRI/Greenwald Research Consumer Engagement in Health Care Survey, 2023. were much more likely to prefer POs over HOPDs for non-MRI imaging. They were also much more likely to prefer POs over both HOPDs and labs for lab services, and much more likely to prefer POs over HOPDs for More plan participants disagreed than agreed with the following statements: specialty medications. ### • Physicians tied to a hospital system are better quality physicians. Figure 1 • I am willing to pay more for a physician that is tied to a hospital system. Health Plan Enrollees Ususally Prefer Physician • Higher costs are an indicator of higher quality. Offices Over Hospital Outpatient Departments Where would you most prefer to have the following services performed? Figure 3 Percentag Ho e sof pita l-Plan Based Out Particip patient Facan ilityts A Phy greeing sician Officeor D Laisag b Ho reeing me With 80% Statements Related to Cost and Quality of Health Care Services 80% 72% How much do you agree with the following statements regarding physicians? 70% 68% 70% Agree Disagree Not Sure 61% 60% 58% 60% 53% 52% 50% 50% 47% 50% 40% 40% 37% 32% 30% 28% 30% 28% 30% 23% 20% 20 20 % % 17% 12% 10% 10% 10% 4% 0% 0% Physicians Tied to a Hospital System I Am Willing to Pay More for a Physician Higher Costs Are an Indicator of Higher Quality MRI Imaging Non-MRI Imaging Lab Services Specialty Medication Distribution Are Better Quality Physicians Who Is Tied to a Hospital System Source: EBRI/Greenwald Research Consumer Engagement in Health Care Survey, 2023. Source: EBRI/Greenwald Research Consumer Engagement in Health Care Survey, 2023. 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