Cost Reminders Reduce Expenses

Costs are a dirty word in medicine. Physicians piously pronounce that they wouldn’t want money to influence their decisions and many patients become irate at the thought that their care might be modified somehow, even if it doesn’t effect outcome, by cost.

A modest study reported in the May Archives of Surgery (behind pay wall) and noted in Healthday found that simple reminders of cost led to more efficient use of a low cost procedure phlebotomy:

“The use of laboratory tests has been rapidly increasing over the past few decades to the point where phlebotomy is a substantial proportion of hospital expenditure, and much of it is unwarranted,” wrote Dr. Elizabeth A. Stuebing, of the University of Miami, and Dr. Thomas J. Miner, of Brown University in Providence, R.I.

At the start of the study, average per-patient daily costs were about $148 and the overall weekly cost was $36,875. During the study, the lowest per-patient phlebotomy charge was $108 (27 percent lower) and the lowest overall weekly cost was $25,311. By the end of the 11-week study, about $55,000 had been saved, according to the researchers.

Medicynical Note: Our non-system provides incentives for utilization not savings. As a result it’s the most expensive and inefficient in the world. We are number one!

Imagine if providers were asked about need and alternatives for expensive interventions and treatments? And reminded about the costs of “necessary” procedures? Imagine if insurers were reminded about costs, administrative costs, duplication and executive salaries.

We do things in health care that make little medical or economic sense. We can continue on the current path, and continue to ration care economically (the republican solution) or do it more rationally.

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