24 September 2022 |

Outside the Huddle 9/25/22

By Jared Dashevsky

New Data: Patients Wait on Average 26 Days for an Appointment

Physician wait times are the longest they’ve ever been, according to the latest data from Merritt Hawkins. Over 1,000 physicians in major metropolitan areas were surveyed with results showing wait times varied between cities and specialties. For example, patients wait on average 84 days for a dermatologist appointment in Portland vs 9 days in Philadelphia. This data likely underestimates the true wait times patients experience, especially in rural areas, since metropolitan areas have a high concentration of physicians. While the Biden administration has added 1,000 residency slots for programs in rural areas to address physician shortages and subsequent long wait times, it’ll be years until the benefits are realized. A couple of weeks ago, I wrote about long patient wait times and how the scheduling process could be more efficient—check it out here.

Republicans Move to Repeal Latest Drug Pricing Reform

House Republicans want to repeal the latest drug pricing reform from the latest Inflation Reduction Act. Part of the drug pricing reform will allow direct negotiations between Medicare and pharma companies over certain high-cost drugs. Republicans argue that allowing Medicare to negotiate drug prices will decrease revenues and stifle drug innovation—the classic argument for not allowing the federal government to negotiate drug prices. Instead of repealing the latest drug pricing reform—which will greatly benefit patients—the government should create a biomedical innovation fund. Two healthcare experts proposed this $20 billion biomedical innovation fund, which they believe will offset drug pricing negotiations by incentivizing innovation. Such a fund may work, given Operation Warp Speed incentives helped produce Pfizer’s vaccine within months of the pandemic.

The No Surprise Billing Act is Off to a Shaky Start

The No Surprise Billing Act, enacted on January 1st of this year, hasn’t found its footing yet: implementation regulations have been incomplete, and enforcement has been nonexistent. I feared that the law’s enforcement would suffer when I wrote about the legislation back in January. Why? Because enforcement of the law is largely based on complaints from patients. But, how educated are patients on the No Surprise Billing Act? Do they know what to do if they receive a surprise medical bill? My guess is few, if any, know what to do if they receive a surprise medical bill. While I applaud the legislation, it needs a software update to make enforcement more robust.

Private Equity Makes its Way into Ophthalmology

Eight percent of the nation’s ophthalmologists now operate under a PE firm’s ownership. Eye care is growing as the age of the population grows, meaning more potential for expensive eye treatment for age-related eye conditions. It appears PE firms are investing heavily in practices where providers are frequently prescribing expensive medications (Lucentis, Avastin) to treat conditions like age-related macular degeneration. Investment into areas that will benefit from the aging population isn’t new. A couple of months ago, I wrote about the Golden Age of Older Rectums and how PE firms have been acquiring gastroenterology practices as the need for colonoscopies increases.

New Anxiety Screening Recommendations for Adults

The U.S. Preventive Services Task Force plans to recommend routine anxiety screenings during primary care visits for all adults under age 65. According to one study, the average time for initiating treatment for anxiety is nearly 25 years. In my article on what mental healthcare will look like in 2032, I included such mental health screenings as a robust tool to ensure disorders like anxiety and depression don’t go untreated.