It’s a little bit of a messy study, sadly, because it’s probably a lovely idea.
These authors performed a before-and-after interventional trial in which they measured laboratory test ordering rates. After a six-month baseline phase, the intervention phase consisted of displaying the 2008 Medicare allowable charge for a subset of frequent lab tests. The theory, of course, is that displaying price information in the context of test ordering will alter physician behavior.
Most of the orders were placed on internal medicine services – and yes, there was a decrease in the number of orders with cost information displayed. At the same time, however, the tests without cost information increased. The net result, overall, was a decrease in total testing. Interestingly, the impact seemed to mostly include a reduction by replacing CMP orders by BMPs. $3.79 per patient-day costs were reduced during the intervention period.
So, the impact was mixed – slightly expensive tests were replaced by slightly less expensive tests. More evaluation is necessary to determine whether these reductions have unanticipated impact on patient outcomes.
“Impact of Providing Fee Data on Laboratory Test Ordering”
www.ncbi.nlm.nih.gov/pubmed/23588900