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Price Transparency Intervention Doesn't Cut Lab Test Orders


HealthDay News
Updated: Apr 24th 2017

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MONDAY, April 24, 2017 (HealthDay News) -- Clinician test-ordering behavior is not affected by displaying Medicare allowable fees in the electronic health record at the time of order entry, according to a study published online April 21 in JAMA Internal Medicine to coincide with the annual meeting of the Society of General Internal Medicine, held from April 19 to 22 in Washington, D.C.

Mina S. Sedrak, M.D., from the City of Hope Comprehensive Cancer Center in Duarte, California, and colleagues examined the effect of displaying Medicare allowable fees for inpatient laboratory tests on clinician ordering behavior over one year. Data were included for 98,529 patients involved in 142,921 hospital admissions between April 2014 and April 2016. A one-year intervention of displaying Medicare allowable fees in the electronic health record at the time of order entry was compared with a one-year preintervention period.

The researchers found that in adjusted analyses, there were no significant changes in overall test-ordering behavior for the intervention versus the control group over time (0.05 tests ordered per patient-day; 95 percent confidence interval [CI], −0.002 to 0.09; P = 0.06) or associated fees (24 cents per patient-day; 95 percent CI, −42 cents to 91 cents; P = 0.47). Based on patient intensive care unit (ICU) stay, there was a small but significant difference in tests ordered per patient-day (patients with ICU stay: −0.16; 95 percent CI, −0.31 to −0.01; P = 0.04; patients without ICU stay: 0.13; 95 percent CI, 0.08 to 0.17; P < 0.001) and in the magnitude of associated fees.

"Displaying Medicare allowable fees for inpatient laboratory tests did not lead to a significant change in overall clinician ordering behavior or associated fees," the authors write.

One author disclosed ties to Catalyst Health.

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