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Patients who choose doctors with low office visit prices save hundreds of dollars per year

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Patients who choose primary care doctors with low office visit prices can rack up considerable savings on overall health care costs, according to new research from Harvard Medical School.

The report, published Dec. 5 in the December issue of the journal Health Affairs, suggests that office visit costs may be a reliable indicator of what a patient will pay for a wide range of services and procedures.

The analysis shows that a relatively small difference in office visit price — $26 — translated into hundreds of dollars in savings over the course of a year. The study found that when patients received care from primary care doctors with lower-than-average office visit prices, they spent, on average, $690 less per year, compared with patients who saw higher-priced physicians.

The savings, the researchers note, were not driven by fewer services or less care. Indeed, there was no significant difference in the kind and amount of services received by the two groups of patients. Rather, patients whose physicians charged lower prices for office visits also paid less for almost every other outpatient service they received.

In the past decade, patients have had to pay more for health care, due to higher deductibles. Many states and private insurers now offer price transparency tools in the hope that access to such information could help people make better-informed decisions on how much they will pay per visit or for a given procedure.

Would picking a provider based on low-priced office visits translate into overall savings including procedures and other follow-up care? The study suggests so.

"Because of the tremendous growth in high-deductible health plans, Americans are being forced to think about prices when they choose where to get care," said study lead author Ateev Mehrotra, associate professor of health care policy at Harvard Medical School and a hospitalist at Beth Israel Deaconess Medical Center. "Our data suggest that looking at the price of your doctor's office visit is a good place to start. Choosing a lower-priced primary care doctor could save someone a lot of money."

Using the 2010 Ingenix insurance database, which contains data from 27 national employers, the researchers grouped primary care doctors into high, average and low price tiers based on the cost of an office visit. From there, they examined the spending of those doctors' patients, looking at how many services such as drugs and emergency care visits patients used and how much the services cost.

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Other investigators on the research included Peter Huckfeldt, assistant professor in the Division of Health Policy and Management at the University of Minnesota School of Public Health; Amelia Haviland, Anna Loomis McCandless Professor of Statistics and Public Policy at the H. John Heinz III College of Public Policy and Management at Carnegie Mellon University; Laura Gascue, programmer and quantitative analyst at the Leonard D. Schaeffer Center for Health Policy and Economics at the University of Southern California, Los Angeles; and Neeraj Sood, professor of public policy at the Leonard D. Schaeffer Center for Health Policy and Economics at the University of Southern California.

The work was funded by the Common Fund of the National Institutes of Health (Grant No. R01 AG043850-01).

Harvard Medical School has more than 9,500 full-time faculty working in 10 academic departments located at the School's Boston campus or in hospital-based clinical departments at 15 Harvard-affiliated teaching hospitals and research institutes: Beth Israel Deaconess Medical Center, Boston Children's Hospital, Brigham and Women's Hospital, Cambridge Health Alliance, Dana-Farber Cancer Institute, Harvard Pilgrim Health Care Institute, Hebrew SeniorLife, Joslin Diabetes Center, Judge Baker Children's Center, Massachusetts Eye and Ear/Schepens Eye Research Institute, Massachusetts General Hospital, McLean Hospital, Mount Auburn Hospital, Spaulding Rehabilitation Network and VA Boston Healthcare System.

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Ekaterina Pesheva
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