More Coverage of Our Out-Of-Pocket Expenses Research


My colleagues and I have been doing lots of research lately on how physicians and patients discuss out-of-pocket expenses during clinic encounters. One of our recent publications has been getting lots of attention, with this being the latest example. I thought I would share it with you:

Recent qualitative findings published in Health Affairs showed that physicians struggled to help patients factor out-of-pocket expenses into their medical decisions.

“Health care consumers cannot expect to make savvy financial decisions if their doctors do not engage with them in productive conversations about the pros and cons of their health care alternatives, including the financial costs,”Peter A. Ubel, MD, professor in the Sanford School of Public Policy at Duke University, told Healio Internal Medicine. “Some physicians say they are reluctant to do so because money talk would contaminate the doctor-patient relationship.”

In 2014, one in three Americans was reported to have difficulty paying health care bills, the researchers wrote. In a previous study, Ubel and colleagues found that patients and physicians discussed strategies to reduce health care expenses about 44% of the time when these topics arose. They also determined, however, that these discussions did not always allow patients to navigate out-of-pocket expenses.

“Many more physicians, I expect, would like to hold such conversations, but struggle to do so because there is no easy way to figure out how much patients will be required to pay out-of-pocket for their medical care,” Ubel said.

In the current study he and his colleagues performed a qualitative study by analyzing physician-patient interactions taken from the Verilogue Point-of-Practice database. They used 677 interactions in breast oncology, 656 in rheumatoid arthritis and 422 in psychiatry that occurred from May 2010 to February 2014 at private practices nationwide.

The researchers found that two broad categories of behaviors led to missed opportunities that could trim out-of-pocket expenses. The first was the physician not acknowledging the seriousness of the patient’s concerns. The second was the physician failing to fully resolve a patient’s financial concerns.

For the first behavior, the researchers cited examples of how physicians missed opportunities to address patient concerns.

To read the rest of this story, please visit Healio.

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