419 Natural Resources Drive • Little Rock, AR 72205 Office: 501-224-7878 • Fax: 501-224-0519 • Search

New Survey Shows Physicians Prefer a Two-Tiered Health System

by Kurt Mosley, Vice President of Strategic Liaisons, Merritt Hawkins

In 2008, Merritt Hawkins conducted its first national physician survey on behalf of The Physicians Foundation, a nonprofit seeking to advance the work of practicing physicians and help them facilitate the delivery of high-quality healthcare to patients. 

Twelve years later, the Survey of America’s Physicians is established as one of the largest and most comprehensive physician surveys conducted in the United States. It provides benchmark data on physician morale and burnout levels, physician career plans and preferences, and physician practice metrics. Merritt Hawkins conducts the survey on a biennial basis for The Physicians Foundation and was set to do so again in April of 2020 when the coronavirus pandemic struck.

Given the impact of Covid-19, The Physicians Foundation determined to complete a special edition of the survey centered around the virus and how it has affected physicians and their patients. The survey was conducted in three parts. Each part focused on a different aspect of Covid-19. Part One, released in August, looked at how the virus has affected physician practices and their patients. Part Two, released in September, examined how the virus has affected physician well-being. Part Three, released in October, reflects future steps physicians believe should be taken to improve the healthcare system in light of the pandemic.

Physicians responding to Part Three were asked to rate four different options for the healthcare system, as follows:

Q. Considering all relevant issues such as patient access, value and quality, health system efficiency, physician autonomy and compensation, and the COVID-19 public health response, what direction should the health care system take? Rank the options below 1-4, with 1 being the best approach.  

  • Maintain/improve the current ACA influenced system - 1:19% 2: 30% 3: 39%  4: 2%      
  • Implement a single payer/Medicare for All system (government funded and administered) - 1:19% 2: 21% 3: 22% 4: 38%        
  • Implement a two-tiered system (single payer available for all, with private pay/insurance option) - 1: 36% 2: 31% 3: 22% 4:11%
  • Move to a market-driven system with Health Savings Accounts - 1: 30% 2: 15% 3:13% 4: 42%

As these numbers indicate, 67% of physicians gave a two-tiered healthcare system featuring single payer insurance available to all, combined with private pay options the highest rating of one or two. The two-tiered option received the highest rating for all physician types, including males, females, primary care physicians and specialists, older and younger physicians and independent physicians and specialists. Other options, such as single payer/Medicare for All and a market-driven system, received some high ratings of one or two but a greater number of lower ratings of three or four.

When asked what immediate policy steps could be made to improve the healthcare system, physicians rated “streamlining/simplifying prior authorizations” as the most important step, followed by simplifying access to mental health services. Physicians also identified “adding more physician leaders” as a key step to be taken to enhance the healthcare system.  

Part Three of the survey includes further data regarding how physicians view the importance of addressing the social determinants of health, limiting or eliminating surprise medical bills, determining the impact on drug costs of Pharmacy Benefit Managers (PBMs) and a range of other topics.

Combined with Parts One and Two, the 2020 Survey of America’s Physicians: Covid-19 Edition, offers valuable insights into how physicians on the front lines of care have been affected by the coronavirus pandemic, how they have reacted to it, and where they believe we should go from here.

Arkansas Hospital Association members may obtain a copy of this timely new resource by contacting Cristina Campanella, Merritt Hawkins Senior Marketing Consultant at cristina.campanella@merritthawkins.com.