Providers Prioritize Quality Care, Not Lower Healthcare Costs
A recent study found that one third of healthcare providers think it is unfair to expect physicians to provide quality care while simultaneously reducing healthcare costs.
By - By now, many healthcare providers are partaking in some form of value-based care, which aims to foster quality care while reducing healthcare costs. To achieve this, value-based care relies on care coordination to decrease unnecessary treatments and hospital admissions.
However, many healthcare organizations are wondering who should be responsible for managing financial stewardships that discourage overuse of services and boost value-based care.
A recent study in the American Journal of Managed Care found that a little over one third of healthcare providers at a major ambulatory care provider in Massachusetts reported that it was unfair to expect physicians to be cost-conscious and focus on patient welfare.
Similarly, about one third of survey participants stated that cost was overemphasized, physicians were too busy to be concerned about costs, and they try not to think about prices.
“Although widely discussed, the healthcare system has been slow to effectively discourage overuse,” wrote the authors of the study. “Patient and physician knowledge and understanding of which tests are low-value is a necessary first step to reduce overuse of services.”
Despite negative views on tracking healthcare costs, most of the providers agreed that physicians are responsible for reducing the number of unnecessary tests (96.8 percent) and controlling healthcare costs (92.2 percent).
Researchers set out to discover how aware physicians were about low-value services and unnecessary tests, specifically through the American Board of Internal Medicine Foundation’s Choose Wisely campaign.
The Choose Wisely initiative was developed in 2012 to strengthen financial stewardships and educate providers on avoiding unnecessary procedures and treatments. Through the program, healthcare providers and patients can access lists of tests, procedures, and treatments that are considered unnecessary or wasteful in most patient cases.
The study showed that the Choose Wisely campaign was a valuable guide for healthcare providers. Almost half of primary care physicians were greatly aware of the initiative, followed by 37.4 percent of medical specialists and 27 percent of surgical specialists. More than 90 percent of all providers surveyed also stated that Choose Wisely was a legitimate resource.
Three-fourths of primary care physicians reported that the campaign caused them to reduce unnecessary services while 64.4 percent of medical specialists and 54 percent of surgical specialists agreed.
Since clinical guides were proven to be effective for lowering healthcare costs, researchers turned the possible drivers of overuse to find out why physicians did not want to focus on healthcare costs.
According to the study, overuse cost drivers included “pressure from patients to order tests, ordering tests to reduce risk of malpractice, finding the uncertainty involved in patient care disconcerting, and not understanding of the costs of tests and procedures to the health system.”
Overall, only 36.9 percent of respondents said that they have a firm understanding of healthcare costs, which could have potentially lead to an increase in overuse of low-value services.
Additionally, more primary care physicians (68.3 percent) reported that they felt substantially more pressure from patients to perform or order low-value services. Only 58 percent of medical specialists and 55.8 percent of surgical specialists felt the same pressure from patients.
In terms of malpractice, the average score on the Malpractice Concerns Scale was 58.1 out of 100, which indicates that the physicians are regularly worried about malpractice. With this in mind, physicians admitted to ordering more unnecessary services to protect themselves from malpractice issues.
Researchers also revealed that physicians reported an average score of 2.7 out of 4 on the Discomfort with Uncertainty Scale. Providers may have performed more avoidable procedures and treatments when it was unknown what was ailing the patient.
By identifying the drivers of overuse, the study intended to help the industry develop more comprehensive financial stewardships that support specific medical fields, such as primary care physicians.
“Initiatives aimed at improving financial stewardship may benefit from efforts targeted at supporting clinicians in dealing with the uncertainty that comes with conservative management,” explained the study. “Physicians may be more willing to forgo or delay low-value care if they have appropriate support that addresses patient demand, malpractice concerns, and other drivers of overuse.”
The study also suggested that healthcare cost information should be accessible to providers through clinical decision support tools.
While physicians explained that they are the best source to lower healthcare costs, the study indicated that all healthcare stakeholders need increase healthcare cost transparency and awareness.
“Reduction of overuse will require more than just engaging physicians, as the behavior of patients, regulators, and other stakeholders also contributes to the consumption of low-value services,” concluded the study. “Improving the value in the US healthcare system will require a multi-faceted approach in which all stakeholders’ beliefs and objectives are taken into consideration so that incentives are aligned for the elimination of the use of low-value services across stakeholder groups.”
Dig Deeper:
• 5 Ways to Cut Costs Through Hospital Revenue Cycle Management
• Top Opportunities to Reduce Wasteful Healthcare Spending
