Why Patients and Care Providers Are Moving Away from Major Hospital Systems

Anthony Hopp, One would think, in these days of COVID-19, that America’s doctors and patients are as reliant on our hospitals as they’ve ever been. And that they’re going to stay that way.

Guess again.

Today, even as the health care system and the economy face strains from the coronavirus and its complications, scores of doctors and patients avoiding large bureaucratic hospitals and instead flocking toward leaner and meaner models of health care.

Professional providers of all types—from surgeons to drug store owners—are focusing on innovation. Even better, they’re now treating patients as consumers who value quality care at reasonable prices they can know in advance.

Walgreens and VillageMD, for instance, have partnered to open primary-care centers in 500 to 700 drugstores over a five-year period. These centers will provide annual check-ups, walk-in appointments, and many other services. Physician-led teams of four people will treat up to 120 patients per day at these mostly 3,300-square-foot locations.

This model is the latest iteration of a trend called decentralized care, in which patients obtain treatment through telehealth services and outpatient surgery centers and clinics rather than by visiting hospitals. Think about it: for two decades, the late Harvard Business professor Clayton Christensen predicted that decentralization in health care would follow other industries on this path, such as travel, retail, and financial services. It was only a matter of time, said Christensen, before health care innovators improved access to services and reduced costs.

That time is now.

Two key factors are driving this emerging trend, as a recent Healthline.com article pointed out: 1) urgent care clinics and expanded pharmacy services are improving the efficiency of health care delivery; and 2) more people, especially older adults, are receiving care at home. Americans who support this free-market health trend share some of the top reasons for its popularity, including convenience and price transparency. The media has been reporting on the trend, too.Yahoo Finance, for example, ran a piece this summer about the expected growth of urgent care centers over the next five years.

Dr. Christopher Vaughn, owner of the free-market medical facility Freedom Orthopedic in Toccoa, Georgia, says his decentralized, direct-pay model allows him to give patients the attention they need—and crave.

“Medically, we are better able to care for patients by being more flexible,” Vaughn said in an interview. “When there is a big medical or financial decision, we can discuss it and see if that is what they want to do. I can use the decision-making skills that I was trained to use after discussing options with the patient. This is without waiting for a third-party, non-medical person inserting himself or herself into our physician-patient relationship. All of this adds up to better health care for patients.”

For the past decade, innovative doctors such as Vaughn have been experimenting with ways to keep patient satisfaction at the core of their practice models, starting with price transparency. For example, the Surgery Center of Oklahoma, founded and operated by Dr. Keith Smith and partners, performs 600 to 700 surgeries per month at prices it posts on its website.

Freedom Orthopedic also posts transparent prices online—and in many cases offers high-quality care for less than 50 percent of the cost, as compared to other facilities.

“Freedom Orthopedic has been able to help patients financially in multiple ways, first by offering pricing that is visible online,” Vaughn said. “The cost to ‘get in the door’ is usually far less than that of half of most orthopedic offices. If somebody needs a cast or injection, that service is included in that visit.”

Today, as more than 1.2 million Americans—including Vaughn himself—have moved to health care sharing, they pay their health care bills directly. So, it behooves them to find out the actual cost of care before they purchase it. Think about it: Would today’s consumers purchase anything else without knowing the price of it beforehand?

“If patients want to check our costs against those that other orthopedic surgeons are offering, they can go to our website,” Vaughn said. “If it helps them negotiate better with the orthopedic surgeons they might be used to seeing, I am happy for them.”

“Our surgical pricing helps them know what their total costs are going to be,” Vaughn continued. “This is often very difficult for most patients to determine, as the cost will include surgery, facility, and anesthesia.”

Too often, patients obtain health care services without asking or knowing the costs ahead of time. Then, weeks or months later, they’re surprised—and potentially crushed—when they finally see the bill. Patients should know upfront from their health care providers—and have absolute clarity about—the cost of a health service before obtaining care.

This is not only a reasonable request for a patient to make. It’s absolutely necessary.

The decentralization of health care comes with spiritual benefits as well. The separation from a hospital system allows physicians such as Vaughn the flexibility to share the Gospel.

“I have the freedom to address a person’s spiritual needs as well as his or her medical needs—and thus I can care for the whole patient,” Vaughn said.

Anthony Hopp is Vice President for External Relations for Samaritan Ministries International, a health care sharing ministry.

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