How Primary Care Physicians Integrate Price Information into Clinical Decision-Making

Journal of General Internal Medicine
August 2016
Schiavoni, K.H., Lehmann, L.S., Guan, W., Rosenthal, M., Sequist, T.D., and Chien, A.T.

Little is known about how primary care physicians (PCPs) in routine outpatient practice use paid price information (i.e., the amount that insurers finally pay providers) in daily clinical practice. In this HCFO-funded study, the researchers used semi-structured interviews and qualitative analysis to describe the experiences of PCPs who have had paid price information on tests and procedures for at least one year. They found that all PCPS were more intersted in having patient-specific price information than paid prices from the practice perspective; price information helped PCPs engage patients in conversations about how to alter treatment plans to make them more affordable; and price information only slightly altered PCPs' test-ordering patterns. The researchers conclude that physician-targeted price transparency efforts may provide PCPs with the information they need to respond to patients' concerns regarding out-of-pocket affordability rather than that needed to change test-ordering habits.

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