Study: Impact of price transparency in EHR unclear
- While more health systems are publicizing prices at point of order entry, its effect on clinician behavior is unclear, a new study concludes.
- Researchers compared changes over a one-year preintervention period and one-year intervention period at three hospitals to see if displaying Medicare allowable fees for inpatient laboratory tests influenced clinician behavior, according to the study published online Friday in JAMA Internal Medicine
- The authors concluded no significant change in ordering behavior or associated fees.
During the preintervention period, the mean associated fee per patient day was $27.77 in the control group and $37.84 in the intervention group. In the intervention period, the fees were $27.59 for controls and $38.85 for the intervention group.
The researchers adjusted the changes for time trends, patient demographics, insurance, disposition and severity of underlying diseases.
“These findings suggest that price transparency alone may not lead to significant changes in clinician behavior, and future price transparency interventions may need to be better targeted, framed, or combined with other approaches, the researchers wrote.
The researchers point to several factors that could explain the results. Transparency of price information for appropriate tests might have lessened its impact when tests were inappropriate. Clinician ordering habits and how the pricing information is framed may also have influenced the outcome, the study says. “Clinicians may have previously believed that the cost of some tests was higher than the price that was displayed,” they noted.
Efforts to improve pricing transparency are growing. A study in New York found that some hospitals are up to 2.7 times more expensive than the lowest-priced hospitals in tie same area, and that those higher prices are being written into contracts with private payers.
Hospital consolidation accounts for some of this difference, as larger systems can wield more clout during pricing negotiations with insurers. However, consumers are demanding more transparent pricing on healthcare. Last summer, Los Angeles startup ZendyHealth launched a “pick-your-price” platform to allow patients to find and book standardized procedures such as dental, orthopedic, sports medicine, Lasik and CT/MRI scans.