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Seeing the cost of lab tests in patients’ health records doesn’t deter doctors from ordering the tests, according to research published in JAMA Internal Medicine.
Results of a large study showed that displaying Medicare allowable fees for inpatient lab tests did not have an overall impact on how clinicians ordered tests.
“Price transparency is increasingly being considered by hospitals and other healthcare organizations as a way to nudge doctors and patients toward higher-value care, but the best way to design these types of interventions has not been well-tested,” said study author Mitesh S. Patel, MD, of the University of Pennsylvania School of Medicine in Philadelphia.
“Our findings indicate that price transparency alone was not enough to change clinician behavior and that future price transparency interventions may need to be better targeted, framed, or combined with other approaches to be more successful.”
In the new study—the largest of its kind—researchers randomly assigned 60 groups of inpatient lab tests to either display Medicare allowable fees in the patient’s electronic health record (intervention arm) or not (control arm).
The trial was conducted at 3 hospitals within the University of Pennsylvania Health System over a 1-year period. Researchers compared changes in the number of tests ordered per patient per day, and associated fees, for 98,529 patients (totaling 142,921 hospital admissions).
In the year prior to the study, when cost information was not displayed, the average number of tests and associated fees ordered per patient per day was 2.31 tests, totaling $27.77, in the control group and 3.93 tests, totaling $37.84, in the intervention group.
After the intervention, when cost information was displayed for the intervention group, the average number of tests and associated fees ordered per patient per day did not change significantly. It was 2.34 tests, totaling $27.59, in the control group, and 4.01 tests, totaling $38.85, in the intervention group.
Though the study showed no overall effect, the researchers noted findings in specific patient groups that have implications for how to improve price transparency in the future.
For example, there was a slight decrease in test ordering for patients admitted to the intensive care unit—an environment in which doctors are making rapid decisions and may be more exposed to the price transparency intervention.
The researchers also found the most expensive tests were ordered less often, and the cheaper tests were ordered more often.
“Electronic health records are constantly being changed, from how choices are offered to the way information is framed,” said study author C. William Hanson, MD, of the University of Pennsylvania Health System.
“By systematically testing these approaches through real-world experiments, health systems can leverage this new evidence to continue to improve the way care is delivered for our patients.”
“Price transparency continues to be an important initiative,” Dr Patel added, “but the results of this clinical trial indicate that these approaches need to be better designed to effectively change behavior.” 
Seeing the cost of lab tests in patients’ health records doesn’t deter doctors from ordering the tests, according to research published in JAMA Internal Medicine.
Results of a large study showed that displaying Medicare allowable fees for inpatient lab tests did not have an overall impact on how clinicians ordered tests.
“Price transparency is increasingly being considered by hospitals and other healthcare organizations as a way to nudge doctors and patients toward higher-value care, but the best way to design these types of interventions has not been well-tested,” said study author Mitesh S. Patel, MD, of the University of Pennsylvania School of Medicine in Philadelphia.
“Our findings indicate that price transparency alone was not enough to change clinician behavior and that future price transparency interventions may need to be better targeted, framed, or combined with other approaches to be more successful.”
In the new study—the largest of its kind—researchers randomly assigned 60 groups of inpatient lab tests to either display Medicare allowable fees in the patient’s electronic health record (intervention arm) or not (control arm).
The trial was conducted at 3 hospitals within the University of Pennsylvania Health System over a 1-year period. Researchers compared changes in the number of tests ordered per patient per day, and associated fees, for 98,529 patients (totaling 142,921 hospital admissions).
In the year prior to the study, when cost information was not displayed, the average number of tests and associated fees ordered per patient per day was 2.31 tests, totaling $27.77, in the control group and 3.93 tests, totaling $37.84, in the intervention group.
After the intervention, when cost information was displayed for the intervention group, the average number of tests and associated fees ordered per patient per day did not change significantly. It was 2.34 tests, totaling $27.59, in the control group, and 4.01 tests, totaling $38.85, in the intervention group.
Though the study showed no overall effect, the researchers noted findings in specific patient groups that have implications for how to improve price transparency in the future.
For example, there was a slight decrease in test ordering for patients admitted to the intensive care unit—an environment in which doctors are making rapid decisions and may be more exposed to the price transparency intervention.
The researchers also found the most expensive tests were ordered less often, and the cheaper tests were ordered more often.
“Electronic health records are constantly being changed, from how choices are offered to the way information is framed,” said study author C. William Hanson, MD, of the University of Pennsylvania Health System.
“By systematically testing these approaches through real-world experiments, health systems can leverage this new evidence to continue to improve the way care is delivered for our patients.”
“Price transparency continues to be an important initiative,” Dr Patel added, “but the results of this clinical trial indicate that these approaches need to be better designed to effectively change behavior.”
Seeing the cost of lab tests in patients’ health records doesn’t deter doctors from ordering the tests, according to research published in JAMA Internal Medicine.
Results of a large study showed that displaying Medicare allowable fees for inpatient lab tests did not have an overall impact on how clinicians ordered tests.
“Price transparency is increasingly being considered by hospitals and other healthcare organizations as a way to nudge doctors and patients toward higher-value care, but the best way to design these types of interventions has not been well-tested,” said study author Mitesh S. Patel, MD, of the University of Pennsylvania School of Medicine in Philadelphia.
“Our findings indicate that price transparency alone was not enough to change clinician behavior and that future price transparency interventions may need to be better targeted, framed, or combined with other approaches to be more successful.”
In the new study—the largest of its kind—researchers randomly assigned 60 groups of inpatient lab tests to either display Medicare allowable fees in the patient’s electronic health record (intervention arm) or not (control arm).
The trial was conducted at 3 hospitals within the University of Pennsylvania Health System over a 1-year period. Researchers compared changes in the number of tests ordered per patient per day, and associated fees, for 98,529 patients (totaling 142,921 hospital admissions).
In the year prior to the study, when cost information was not displayed, the average number of tests and associated fees ordered per patient per day was 2.31 tests, totaling $27.77, in the control group and 3.93 tests, totaling $37.84, in the intervention group.
After the intervention, when cost information was displayed for the intervention group, the average number of tests and associated fees ordered per patient per day did not change significantly. It was 2.34 tests, totaling $27.59, in the control group, and 4.01 tests, totaling $38.85, in the intervention group.
Though the study showed no overall effect, the researchers noted findings in specific patient groups that have implications for how to improve price transparency in the future.
For example, there was a slight decrease in test ordering for patients admitted to the intensive care unit—an environment in which doctors are making rapid decisions and may be more exposed to the price transparency intervention.
The researchers also found the most expensive tests were ordered less often, and the cheaper tests were ordered more often.
“Electronic health records are constantly being changed, from how choices are offered to the way information is framed,” said study author C. William Hanson, MD, of the University of Pennsylvania Health System.
“By systematically testing these approaches through real-world experiments, health systems can leverage this new evidence to continue to improve the way care is delivered for our patients.”
“Price transparency continues to be an important initiative,” Dr Patel added, “but the results of this clinical trial indicate that these approaches need to be better designed to effectively change behavior.”