7 strategies to boost medical practice revenue by leveraging patient interest in GLP-1 medications

About 1 in 8 United States adults have taken a GLP-1 receptor agonist, an increasingly popular class of prescription drugs used for weight loss, diabetes treatment, and cardiovascular disease prevention — as well as to help control inflammatory disease. And a recent proposal from the Centers for Medicare & Medicaid Services (CMS) to expand coverage of GLP-1 medications signals potential growth ahead. 

If finalized, starting January 1, 2026, Medicare and Medicaid would permit coverage for patients who need anti-obesity medications to reduce and maintain weight reduction long-term. Currently, Medicare Part D plans’ guidelines cover GLP-1 medication — but only for type 2 diabetes and cardiovascular disease treatment. As of August 2024, while 13 states under Medicaid fee-for-service contracts cover GLP-1 medications for obesity treatment, most require prior authorizations. 

As patient demand for these medications grows, medical practices face mounting administrative pressures — as well as an opportunity for increased revenue. Insurance coverage presents a significant challenge for specialty medications, as many health plans explicitly exclude these drugs. Even submitting prior authorization requests won't overcome this fundamental barrier to coverage.  

To manage this increased workload and increase revenue, practices will likely need to hire dedicated staff members to handle these authorization requests. Given the substantial time and resources required, some medical offices have begun implementing fees for every authorization done.

Read on for tips to prepare your practice for a surge in interest in GLP-1 medications.

As more patients express interest in GLP-1 medications for weight loss, it will be important for medical practices to anticipate a potential uptick in appointment requests and to identify and pursue any associated opportunities to increase practice revenue. 

Here are 7 strategies to increase revenue and optimize GLP-1 patient education.

As the demand for GLP-1 medications and patient education grows with the potential for expanded Medicare and Medicaid coverage, front-office staff may see an uptick in calls related to setting up appointments for initial evaluations. 

Likewise, they may start to notice increased inquiries about renewing prescriptions or requesting callbacks about medication side effects. Streamlining these calls and/or patient portal messages will be important to ensure timely responses to grow patient volumes and increase practice revenue.

It’s also essential to protect access for new patients seeking appointments while managing this surge in call volume. Consider updating your practice website with detailed information about GLP-1 medications to address common questions. 

Adding an online appointment request system would also be valuable, as this allows patients to submit their scheduling needs at any time. To make this system most effective, consider designating a staff member to handle these online requests and serve as a dedicated resource for GLP-1-related inquiries. 

Virtual health programs for GLP-1 medications allow patients to consult healthcare providers via video calls, phone calls, or secure messaging. 

Leveraging telehealth may make it easier for providers to accommodate new and existing patients and increase access to the practice, as many patients are unable to take time off work for an in-person appointment — and telehealth enables patients to have a virtual visit during a break at work or after the work day ends.

For physicians prescribing GLP-1 medications, electronic workflows will ease administrative burdens and increase efficiency by enabling them to reference medication history and monitor patient information easily. 

A well-configured eRx system, integrated with your EHR, can streamline prior authorizations, track medication adherence, and minimize prescription-related callbacks that interrupt clinical workflows. This not only improves practice efficiency but also enhances the patient experience by reducing delays in medication access.

Having integrated electronic prescribing is essential and greatly streamlines the process, as it often takes an extended amount of time to go through the patient’s chart to find the necessary information, such as the last dose and the last HbA1c. Complicating matters is the fact that most automated pharmacy requests will ask the provider for the previous dose to be renewed when, in fact, the dose should be increased monthly for maximal weight loss and benefit, as tolerated by the patient.

Consider providing patients with fact sheets about GLP-1 medications like this one or this one. When thinking about GLP-1 patient education, medical practices may also want to consider creating a list of all local pharmacies within a certain radius, as well as mail-order pharmacies that patients can call to access GLP-1 medications during times of medication shortages. 

Patient resources to address medication costs are also essential to GLP-1 patient education. This article specifically mentions compound medications as well as drug manufacturer coupons and lower-cost versions of the drugs. Medical practices can provide these resources through the patient portal, on the practice website, or in person. 

These efforts to educate and support patients can greatly enhance patient engagement and retention and may even improve patient outcomes.

When prescribing GLP-1 medications, it’s important to understand what each payer requires. This includes any steps patients must take and what specific clinical documentation is required for approval. Creating cheat sheets can help streamline the process and avoid unnecessary rework.

Effective October 1, 2024, 3 new ICD-10-CM codes for obesity took effect, which present both a compliance requirement and also a revenue opportunity for medical practices These new codes classify the diagnosis into 3 distinct categories based on severity:

Providers should use the new E codes together with the existing adult BMI Z codes as described here. For pediatric patients, use a new set of Z-codes based on age- and gender-specific BMI percentiles (i.e., Z68.54–Z68.56). Note that it’s important to update the Z code, as necessary, when a patient’s BMI changes. The increased specificity of these codes can support medical necessity documentation for GLP-1 medications and related services. 

Many patients on GLP-1 medications may benefit from additional services. This creates opportunities to increase medical practice revenue through medical nutrition therapy (i.e., CPT codes 97802–97804), individual preventive medicine counseling (i.e., CPT codes 99401–99404), or group preventive medicine counseling (i.e., CPT codes 99411–99412). 

Medical practices may also be able to report G0270–G0271 when there has been a change in the patient’s diagnosis, condition, or treatment regimen. In addition, patients taking GLP-1 medications may also qualify for other services like chronic care management. Identifying billable opportunities helps increase medical practice revenue.

Increased interest in GLP-1 medications is more than just a clinical trend; it’s an opportunity for medical practices looking to engage patients and increase medical practice revenue streams. By implementing streamlined workflows, leveraging technology, and staying current with coding requirements, practices can efficiently manage the increasing volume of patients seeking these medications. 

The key to success lies in preparation: ensuring your staff is well-trained, your systems are optimized, and your GLP-1 patient education resources are ready. Doing so lays the foundation for success.