Why is it that no one knows what healthcare costs? How much does a simple pill cost? Well that depends on where you buy it. The same pill has a different price whether you buy it at Walmart, the grocery-store or at a hospital pharmacy.
While buying a pill at the grocery-store is a simple transaction, the process has many steps that secure the cold chain and other traceable steps through distribution. At a hospital, pills from the pharmacy also has many checks and steps. Nurses are needed to administer, document and verify that the right pill is order and to comply with healthcare regulations. Additionally, there’s overhead and limited space, time and manpower which drives up the total cost of the transaction.
How does this really impact care?
Dispensing and administering a drug is just an example that can be extrapolated to each device, service, operation, test… well every order that is written to help care for a patient. The cost of care is more than ordering a pill.
Interestingly, doctors do not know the cost of the orders they place.
And for good reason. The care provided to a patient should be determined by what will ensure the best outcome for the patient, and not what will lower the cost. Doctors are writing orders; being an advocate for the patient.
Can data change behavior? I think so. If the cost of care is shown (cost of the drug and alternatives for example) to the ordering physician, it will give an idea of where that particular care stands, when compared to other similar treatments..
This could be used for an individual patient or as a comparison of Doctor A vs. Doctor B in caring for similar patients that had similar outcomes.
Could a bar graph showing Doctor A that the cost of his current care is higher, lower or comparable to the cost of similar doctors help achieve a lower average cost and yet provide good patient care?
EHR systems can be configured to have average costs for diagnostic tests, laboratory tests, respiratory treatments, home health aids (walkers, special beds) and the costs of alternatives. Instead of estimating a single cost, doctors could be provided a range of alternative care costs.
Could a CT scan be used instead of an MRI? Well, that depends on what is being investigated. Radiologists can determine the appropriate test but not all ordering physicians can. Likewise, some DNA tests that are ordered cost more than others but insurance covers them all.
Costs, expenses, insurance reimbursement – these are complex. Why not just let the ordering clinicians know the cost of their orders? Maybe, behavior would change. Maybe costs would rise at a slower rate. Maybe fiscal responsibility would improve.
Recent Comments