Patients, Providers Recognize Increased Risks From Care Variation

November 26, 2019 - An overwhelming majority (98 percent) of consumers, hospital executives, physicians, and nurses agreed that healthcare cost and care variations exist.

That was the latest finding from Wolters Kluwer, which commissioned Regina Corso Consulting in June 2019 to survey nearly 2,000 consumers, nurses, doctors, and healthcare executives. The survey found that patients and providers alike know about cost and care variations and acknowledge that these differences are increasing risks.

The survey found two-thirds of consumers do not believe they would be charged the same for a treatment or condition regardless of where they received care. Providers were also aware of differences in cost and care.

Ninety-two percent of hospital executives, 91 percent of physicians, and 86 percent of nurses were aware of cost differences for the same medicines. Additionally, 87 percent of hospital executives, 90 percent of physicians, and 84 percent of nurses acknowledged cost differences for the same care.

Many providers also recognized care differences within the same organizations. Sixty-three percent of hospital executives, 69 percent of physicians, and 65 percent of nurses said care was not delivered the same way across care settings or departments in the hospital.

READ MORE: Location, Market Competition Influence Hospital Price Variation

Patients and providers were fully aware that cost and care variations are occurring, and both groups agreed that these differences are posing risks.

Fifty-two percent of consumers surveyed said the greatest risk to them is when providers prescribe them medications and they don’t fill them because of cost. Nearly one-half (47 percent) of consumers also said they don’t take drugs as prescribed and 38 percent said they stop taking a medication before treatment should end.

In addition, 61 percent of younger consumers and 31 percent of older consumers said they would not move forward with a medical treatment because of cost concerns.

Consumers also reported that they are willing to seek care at an alternative facility when they uncover healthcare cost and care variations. Four in five consumers said they were likely to travel past the hospital closest to them if a nearby facility has a better reputation, the survey found.

For providers, suboptimal care was the greatest risk to patients. Respondents working in the healthcare system also identified wrong treatment and/or wrong medications due to incomplete or incorrect information and lack of care team alignment on the best care approach or management for the patient as top risks to patients.

READ MORE: Providers Skeptical Practice Variation Reduction Will Lower Costs

These top three risks to the patient also impacted the healthcare system as a whole, provider respondents added. They also said care variations pose a risk to the healthcare system by negatively impacting patient experience, producing different patient outcomes for the same procedure or treatment, and incurring wasteful costs.

Reducing unwarranted cost and care variations is the key to improving outcomes and lowering costs, according to industry experts.

Bart Hill, MD, vice president and chief quality officer of St. Luke’s Health System, for example, attributed the organization’s reductions in emergency department wait time, in-hospital deaths, complications, and length of stay to data-driven, evidence-based care standardization.

“When you standardize your processes and you perform consistently, we have seen fewer of those occurrences that ultimately add extra cost without value, such as readmissions, longer lengths of stay, and more complications,” he told RevCycleIntelligence.com in 2017.

Methodist Le Bonheur Healthcare in Tennessee also improved financially after focusing on clinical variation reduction, according to a 2018 Advisory Board analysis. The integrated health system yielded over $800,000 in cost savings and revenues after launching efforts to reduce care variations in 2014.

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“Embarking on a journey to reduce care variation can be challenging, but our success is due to dedicated teams of physicians, nurses and administrators, all working toward the common goal of improving every life touched at Methodist Le Bonheur Healthcare,” Arthur Townsend IV, MD, MBA, chief clinical transformation officer for Methodist Le Bonheur Healthcare, stated in the analysis.

Many providers are taking steps to reduce cost and care variations. But consumers in the Wolters Kluwer survey are calling on hospitals to concentrate on medication costs.

Forty percent of consumers surveyed said a top priority of hospitals in the near future should be to respond to medication cost increases. All healthcare respondents also saw the need to better align care teams in order to get everyone practicing based on the same evidence.

Both consumers and providers also wanted to see more comprehensive patient data and warm care hand-offs to prevent cost and care variations.

Overall, all respondents see technology as the path forward. More than three in four respondents said the availability of data will contribute to better care, and the majority of stakeholders said technology that connects disparate patient data and supports evidence-based decision-making will lead to better outcomes and lower costs.