A Randomized Trial of Displaying Paid Price Information on Imaging Study and Procedure Ordering Rates

Journal of General Internal Medicine

Volumn 32, Issue 4, 2017, Pages 434-448

  Chien, Alyna T ^a,b   Lehmann, Lisa Soleymani ^a,c,d,e   Hatfield, Laura A ^a   Koplan, Kate E ^f   Petty, Carter R ^b   Sinaiko, Anna D ^c   Rosenthal, Meredith B ^c   Sequist, Thomas D ^d,e,g  

^a HARVARD MEDICAL SCHOOL   (United States)

^b BOSTON CHILDREN S HOSPITAL   (United States)

^c HARVARD SCHOOL OF PUBLIC HEALTH   (United States)

^d BRIGHAM AND WOMEN S HOSPITAL   (United States)

^e VETERANS AFFAIRS MEDICAL CENTER   (United States)

^f KAISER PERMANENTE   (United States)

^g PARTNERS HEALTHCARE   (United States)

Author keywords

electronic health record; health services research; randomized trials

Indexed keywords

ACCOUNTABLE CARE ORGANIZATION; ADULT; ARTICLE; CONTROLLED STUDY; ELECTRONIC HEALTH RECORD; HUMAN; INFORMATION; MEDICAL SPECIALIST; MIDDLE AGED; PARAMEDICAL PERSONNEL; PRIMARY MEDICAL CARE; PROSPECTIVE PRICING; RANDOMIZED CONTROLLED TRIAL (TOPIC); CLINICAL DECISION MAKING; CLINICAL PRACTICE; COST CONTROL; DIAGNOSTIC IMAGING; ECONOMICS; HEALTH CARE COST; HEALTH SERVICES RESEARCH; MASSACHUSETTS; PROCEDURES; RANDOMIZED CONTROLLED TRIAL; STATISTICS AND NUMERICAL DATA; UNNECESSARY PROCEDURE; UTILIZATION;

ACCOUNTABLE CARE ORGANIZATIONS; ADULT; CLINICAL DECISION-MAKING; COST CONTROL; DIAGNOSTIC IMAGING; ELECTRONIC HEALTH RECORDS; HEALTH CARE COSTS; HEALTH SERVICES RESEARCH; HUMANS; MASSACHUSETTS; PRACTICE PATTERNS, PHYSICIANS'; UNNECESSARY PROCEDURES;

EID: 85001133443     PISSN: 08848734     EISSN: 15251497     Source Type: Journal    
DOI: 10.1007/s11606-016-3917-6     Document Type: Article

References (40)

1. Bentley TG, Effros RM, Palar K, Keeler EB. Waste in the US health care system: a conceptual framework. Milbank Q. 2008;86(4):629–659. doi:10.1111/j.1468-0009.2008.00537.x.
2. Boyd C, Darer J, Boult C, Fried L. Clinical practice guidelines and quality of care for older patients with multiple comorbid diseases: implications for pay for performance. JAMA. 2005;294(6). http://jama.jamanetwork.com/article.aspx?articleid=201377. Accessed 21 Oct 2016.
3. Rathod RH, Farias M, Friedman KG, Graham D, Lock JE. A novel approach to gathering and acting on relevant clinical information: SCAMPs. 2012;5(4):343–353. doi:10.1111/j.1747-0803.2010.00438.x.A.
4. Crosson F. Change the microenvironment. Delivery system reform essential to control costs. Mod Healthc. 2009;27(39):20–21.
5. Cohen DI, Jones P, Littenberg B, Neuhauser D. Does cost information availability reduce physician test usage?: a randomized clinical trial with unexpected findings. Med Care. 1982;20(3):286–292. doi:10.2307/3764297.
6. Tierney WM, Miller ME, McDonald CJ. The effect on test ordering of informing physicians of the charges for outpatient diagnostic tests. N Engl J Med. 1990;322(21):1499–1504. doi:10.1056/nejm199005243222105.
7. Bates DW, Kuperman GJ, Jha A, et al. Does the computerized display of charges affect inpatient ancillary test utilization? Arch Intern Med. 1997;157(21):2501–2508.
8. Durand DJ, Feldman LS, Lewin JS, Brotman DJ. Provider cost transparency alone has no impact on inpatient imaging utilization. J Am Coll Radiol. 2013;10(2):108–113. doi:10.1016/j.jacr.2012.06.020.
9. Everett GD, deBlois CS, Chang PF, Holets T. Effect of cost education, cost audits, and faculty chart review on the use of laboratory services. Arch Intern Med. 1983;143(5):942–944. doi:10.1001/archinte.1983.00350050100019.
10. Pugh JA, Frazier LM, DeLong E, Wallace AG, Ellenbogen P, Linfors E. Effect of daily charge feedback on inpatient charges and physician knowledge and behavior. Arch Intern Med. 1989;149(2):426–429.
11. Hampers L, Cha S, Gutglass D. The effect of price information on test-ordering behavior and patient outcomes in a pediatric emergency department. Pediatrics. 1999. http://pediatrics.aappublications.org/content/103/Supplement_1/877.short. Accessed 21 Oct 2016.
12. Marton KI, Tul V, Sox HC. Modifying test-ordering behavior in the outpatient medical clinic. A controlled trial of two educational interventions. Arch Intern Med. 1985;145(5):816–821. doi:10.1001/archinte.1985.00360050060009.
13. Gama R, Nightingale P, Broughton PM, et al. Modifying the request behaviour of clinicians. J Clin Pathol. 1992;45(3):248–249. http://jcp.bmj.com/content/45/3/248.abstract. Accessed 21 Oct 2016.
14. Sachdeva R, Jefferson L, Coss-Bu J, et al. Effects of availability of patient-related charges on practice patterns and cost containment in the pediatric intensive care unit. Crit Care Med. 1996;24(3):501–506. http://journals.lww.com/ccmjournal/Abstract/1996/03000/Effects_of_availability_of_patient_related_charges.22.aspx. Accessed 21 Oct 2016.
15. Schroeder S, Kenders K, Cooper J, Piemme T. Use of laboratory tests and pharmaceuticals: variation among physicians and effect of cost audit on subsequent use. JAMA. 1973;225(8):969–973. http://jama.jamanetwork.com/article.aspx?articleid=350098. Accessed 21 Oct 2016.
16. Feldman LS, Shihab HM, Thiemann D, et al. Impact of providing fee data on laboratory test ordering: a controlled clinical trial. JAMA Intern Med. 2013;173(10):903–908. doi:10.1001/jamainternmed.2013.232.
17. Berwick D, Coltin K. Feedback reduces test use in a health maintenance organization. JAMA. 1986;255(11):1450–1454. http://jama.jamanetwork.com/article.aspx?articleid=403313. Accessed 21 Oct 2016.
18. Horn DM, Koplan KE, Senese MD, Orav EJ, Sequist TD. The impact of cost displays on primary care physician laboratory test ordering. J Gen Intern Med. 2014;29(5):708–714. doi:10.1007/s11606-013-2672-1.
19. Fang DZ, Sran G, Gessner D, et al. Cost and turn-around time display decreases inpatient ordering of reference laboratory tests: a time series. BMJ Qual Saf. 2014;23(12):994–1000. doi:10.1136/bmjqs-2014-003053.
20. Tierney W, Miller M, Overhage J, Mcdonald C. Physician inpatient order writing on microcomputer workstations—effects on resource utilization. JAMA. 1993;269(3):379–383. doi:10.1001/jama.269.3.379.
21. Sinaiko AD, Rosenthal MB. Increased price transparency in health care—challenges and potential effects—NEJM. N Engl J Med. 2011:891–894. doi:10.1056/NEJMp1100041.
22. Shortell SM, Wu FM, Lewis VA, Colla CH, Fisher ES. A taxonomy of accountable care organizations for policy and practice. Health Serv Res. 2014;49(6):1883–1899. doi:10.1111/1475-6773.12234.
23. Song Z, Safran D, Landon B, Landrum M. The “Alternative Quality Contract” in Massachusetts, based on a global budget, lowered medical spending and improved quality. Health Aff. 2012. http://content.healthaffairs.org/content/31/8/1885.long. Accessed 21 Oct 2016.
24. Sequist T, Schneider E. Quality monitoring of physicians: linking patients’ experiences of care to clinical quality and outcomes. JGIM. 2008:1784–1790. doi:10.1007/s11606-008-0760-4.
25. Sequist T. Physician performance and racial disparities in diabetes mellitus care. Arch Intern Med. 2008;168(11):1145–1151. http://archpsyc.jamanetwork.com/article.aspx?articleid=414277. Accessed 21 Oct 2016.
26. Sequist T, Adams A. Effect of quality improvement on racial disparities in diabetes care. Arch Intern Med. 2006;166:675–681. http://archpedi.jamanetwork.com/article.aspx?articleid=410023. Accessed 21 Oct 2016.
27. Schiavoni KH, Lehmann LS, Guan W, Rosenthal M, Sequist TD, Chien AT. How primary care physicians integrate price information into clinical decision-making. J Gen Intern Med. 2016. doi:10.1007/s11606-016-3805-0.
28. Isaac T, Rosenthal MB, Colla CH, et al. Specificity of Overuse Measurement Using Structured Data from Electronic Health Records: A Chart Review Analysis. (In Progress).
29. Rosenberg A, Agiro A, Gottlieb M, et al. Early trends among seven recommendations from the choosing wisely campaign. JAMA Intern Med. 2015;19801(12):1. doi:10.1001/jamainternmed.2015.5441.
30. Consumer Reports. Choosing Wisely campaign brochures. http://consumerhealthchoices.org/campaigns/choosing-wisely/#materials. Accessed 21 Oct 2016.
31. (NQMC) NQMC. Colorectal cancer screening: percentage of patients 50 to 75 years of age who had appropriate screening for colorectal cancer. https://www.qualitymeasures.ahrq.gov/content.aspx?id=48811.
32. Agency for Healthcare Research and Quality. Chronic Condition Indicator (CCI) for ICD-9-CM. http://www.hcup-us.ahrq.gov/toolssoftware/chronic/chronic.jsp. Accessed 21 Oct 2016.
33. Allan GM, Lexchin J. Physician awareness of diagnostic and nondrug therapeutic costs: a systematic review. Int J Technol Assess Health Care. 2008;24(2):158–165. doi:10.1017/s0266462308080227.
34. Torgerson DJ. Contamination in trials: is cluster randomisation the answer? BMJ. 2001;322(7282):355–357.
35. Jones SS, Rudin RS, Perry T, Shekelle PG. Health information technology: an updated systematic review with a focus on meaningful use. Ann Intern Med. 2014;160(1):48–54. doi:10.7326/M13-1531.
36. Whaley C, Schneider Chafen J, Pinkard S, et al. Association between availability of health service prices and payments for these services. JAMA. 2014;312(16):1670–1676. doi:10.1001/jama.2014.13373.
37. Ginsburg S, Bernabeo E, Holmboe E. Doing what might be “Wrong”. Acad Med. 2014;89(4):664–670. doi:10.1097/ACM.0000000000000163.
38. Sabbatini AK, Tilburt JC, Campbell EG, Sheeler RD, Egginton JS, Goold SD. Controlling health costs: physician responses to patient expectations for medical care. J Gen Intern Med. 2014;29(9):1234–1241. doi:10.1007/s11606-014-2898-6.
39. Reuben DB, Cassel CK. Physician stewardship of health care in an era of finite resources. JAMA. 2011;306(4):430–431. doi:10.1001/jama.2011.999.
40. Chien AT, Rosenthal MB. Waste not, want not: promoting efficient use of health care. Ann Intern Med. 2013;158(1):67–68.