Medical Transparency Could Save Doctors And Patients Money

Brett Smith for – Your Universe Online

Transparency allows for consumers to make informed decisions on everything from fast food to automobiles.The same could be held true for physicians, allowing them to order considerably fewer tests or search for lower-priced alternatives when shown the costs of diagnostic procedures, if this transparency was available to them, according to a new study published in JAMA Internal Medicine.

In a study performed at Johns Hopkins Hospital, the researchers found making price information available decreased overall use of certain tests by about 9 percent. This level of transparency is different from typical hospital practices that attempt to shield both patients and physicians from the true cost of medical services.

“We generally don’t make decisions based on what is cost-effective or what is known to be absolutely necessary for our patients, but knowing the cost of things appears to make us more thoughtful about what we think might be best for their health,” said Dr. Leonard S. Feldman, a professor of medicine at the Johns Hopkins University School of Medicine who worked on the study. “There’s a lot of waste in medicine because we don’t have a sense of the costs of much of what we do.”

For the study, the Johns Hopkins team focused on 62 diagnostic blood tests frequently ordered for patients at the hospital. The tests were divided into two groups, with prices attached to only one of the groups. From November 2009 to May 2010, the researchers tracked the rates at which each of the 62 tests was ordered.

The researchers found an approximate 9 percent reduction in the cost-attached tests and a 6 percent rise in the cost-hidden tests. The study found a savings of more than $400,000 over six months.

“Our study offers evidence that presenting providers with associated test fees as they order is a simple and unobtrusive way to alter behavior,” Feldman said in a statement. “In the end, we ordered fewer tests, saved money and saved patients from extra needle sticks without any negative outcomes.”

The researchers found some lower cost tests saved a few dollars compared to higher priced alternatives, but when those savings were compounded over six months — they added up to thousands of dollars.

“It’s like getting practitioners to switch from a $3.50-a-day latte habit to a cheaper $1-a-day cup of regular coffee,” said co-author Dr. Daniel J. Brotman, an associate professor of medicine at the Johns Hopkins University School of Medicine.

The doctor added making medical decisions based on cost is considered by many to be taboo in the industry, potentially leading to rationing and compromising of care. However, Brotman said making these decisions without cost consideration has contributed to an astronomical rise in health care spending and waste.

“There’s no other area of our lives in which we don’t even think about costs,” Feldman said. “If one test costs three times what another does and provides basically the same information, that’s a pretty easy decision. We need to give that information to those who need it, and we really have done a disservice to society by having our head in the sand about costs.”

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