Displaying Medicare price data in EHRs won’t reduce unnecessary tests

Lab work
Including price data in EHRs won't necessarily reduce the number of unnecessary labs, according to new research.

The high costs associated with unnecessary testing in healthcare have spurred a movement to reduce such tests, but new research shows EHRs might not be the best vehicle.

Incorporating price transparency into EHRs at the time physicians order lab tests is one tactic that some hospitals have used in an attempt to reduce wasteful lab testing. But in a study published in JAMA Internal Medicine, researchers at the University of Pennsylvania Health System found displaying Medicare fees for inpatient lab tests had almost no impact on physician ordering.

Authors of the study introduced Medicare allowable cost data into EHRs at three different hospitals within the University of Pennsylvania Health System so physicians could see the cost of the test as they ordered it. Over the course of a year, researchers found no significant difference in physician ordering habits—the average number of ordered tests and the associated fees for each patient-day remained virtually the same.

However, researchers did highlight two potential bright spots that could benefit from additional research. There was a “small but significant decrease” among the most expensive tests as well as the least expensive tests, an indication that price transparency efforts may be better served by targeting only certain high-cost tests.

RELATED: Hospital-based primary care clinics more likely to order unnecessary tests and services

An accompanying editorial acknowledged the disconnect between anecdotal evidence that shows physicians and patients want better access to price transparency and the studies that have incorporated Medicare fees at the point-of-care, but urged healthcare to redouble its efforts.

“This does not mean we should give up on increased price transparency in health care,” the authors wrote. “Rather, a more thoughtful approach to the design, point of delivery, and context for health care price information is needed to achieve the promise of price transparency.”

Last year, the University of Utah rolled out a new software system designed to cut down on common, potentially unnecessary lab tests that cost the system as much as $1.5 million per year. Recent research shows hospital-based primary care clinics frequently order too many tests.