Physician Practice

High-deductible health plans changing patient behavior

Physician Practice Insider, April 5, 2016

Physicians are taking a more active role in discussing costs up front with patients, according to a recent study published in the Medical Decision Making journal.

The study found that about one-third of patient encounters in the study group included a discussion about costs, and many included strategies for lowering the cost of care in proposed treatment plans.

The study looked at conversations between physicians and patients with preexisting conditions in 1,755 outpatient visits in community-based physician offices throughout the U.S. The study population included 677 patients with breast cancer, 422 patients with depression, and 656 patients with rheumatoid arthritis who visited with 56 oncologists, 36 psychiatrists, and 26 rheumatologists. Visits occurred in 34 states and dealt with a wide variety of issues related to each patient population.

Overall, cost-saving strategies were discussed most often between patients and psychiatrists, with 38% of patient visits touching on the subject. Rheumatoid arthritis patients were second, at 33%, and breast cancer patients were third, with 22%. The two most commonly discussed payment reduction strategies were changing health plans and reducing costs with an existing plan using piecemeal strategies such as options to reduce prescription drug costs. Other cost-reduction plans included switching to lower-cost therapies and less expensive diagnostic tests. For breast cancer patients, those strategies included switching from oral cancer therapy drugs with high co-pays to lower-cost intravenous therapies that produced similar results.

But the study authors noted that such strategies were limited in scope. "In general, switching to a lower-cost alternative almost exclusively applied to medications; however, there were a few instances in which physicians and patients discussed switching to lower-cost alternatives for procedures," they stated.

This article was originally published in Physician Practice Perspectives. Subscribers can read the full article in the May 2016 issue.

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