Friday, April 4, 2014

Ignorant About Costs, Interested in Learning

Survey after survey shows: physicians rarely have any idea about the costs of medical care.  And, this is unsurprising – as there is a complex divorce between hospital charges, reimbursements, and ultimate expenses shouldered by patients.  Considering all these variables, it is nigh impossible to clearly communicate the cost of care to an individual in a patient care setting.

But, a ballpark estimate would be nice.

So, how do physicians do with their ballpark estimates of the costs of routine tests and procedures in the Emergency Department?

Using CMS reimbursement rates from 2012 and 2013, this survey of 97 emergency physicians representing 11 EDs in the Salt Lake City area finds they’re usually nowhere close.  Of all the tests and procedures surveyed, only 17% of physician estimates were within ± 25% of the actual CMS reimbursement.  We would be awful on the Price is Right.

Interestingly, the estimates varied widely.  With regards to lab tests and radiology, physicians tended to over-estimate reimbursement by >50%, while under-appreciating the charges associated with CPT codes for administration of IV fluids and IV antibiotics.  I’m not sure how to describe the host of interesting information graphics and tables detailing the bewildering range of inaccuracy, but suffice to say – we could/should/need to do a lot better.

At least, however, physicians self-rated their knowledge of costs of care as low, and over 80% wished they knew more about the charges.  So, hope is not lost – and movements like (the aptly named) Costs of Care ought to receive ready and enthusiastic audience.

“Emergency physician knowledge of reimbursement rates associated with emergency medical care”
http://www.ncbi.nlm.nih.gov/pubmed/24657227

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