Although most emergency departments across the U.S. overcharge patients for their services, a new study finds that 62% of emergency medicine clinicians can’t accurately estimate costs of care.
On average, the study found that only 38% of the 441 emergency medicine professionals surveyed—including physicians, physician assistants, residents and nurse practitioners—accurately estimated the costs for three common conditions seen in the emergency department.
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The findings were published in The Journal of the American Osteopathic Association.
Researchers asked ER clinicians in an internet survey to identify the cost of care for three common complaints: A 35-year-old woman with abdominal pain, a 57-year-old man with labored breathing and a 7-year-old boy with a sore throat. Each survey participant received a medical history, focused physical exam findings, diagnostic tests and intervention, as well as four cost ranges for each scenario.
Only 43% of the respondents correctly identified the costs of care for the scenario that involved the woman with abdominal pain. Thirty-two percent correctly identified the costs of care for the man with the labored breathing and 40% were able to identify the appropriate cost range for services involved to treat the child with the sore throat.
Using 3 patient ED scenarios, HCPs were asked how much they thought the bill would be. @KhoffmanEM https://t.co/PlqYXkPAJd #costofcare
— The JAOA (@TheJAOA) May 31, 2017
The location of the facility had no bearing on the correct answers, but those who work in larger institutions tended to estimate higher costs of care. Although respondents who had higher levels of training believed they had a greater understanding of costs, they performed no better in accurately selecting the correct range.
The findings show that ER professionals have an inadequate understanding of the costs of care they provide and demonstrates the need for price transparency in the ER, lead researcher Kevin Hoffman, D.O., an emergency medicine resident at Lakeland Health in Saint Joseph, Michigan, said in a study announcement.
He says all physicians must take responsibility to control costs for patients and the healthcare system. But it’s even more critical to identify effective and affordable treatment options in the ER, Hoffman says, because in many cases treatment can financially cripple uninsured patients. He suggests that hospitals could help lower the costs of care if they added the price of tests and medications to their order entry systems.
"It's a good tool that helps doctors make a connection between the treatment they're providing and the bill that's going to hit the patient—or in many cases, the taxpayers," Hoffman said. "If I order a drug to be given via IV, it's going to be a lot more expensive than if I give it orally, as a pill. In many cases, both are equally effective."
Hoffman told Forbes that while physicians shouldn’t make medical decisions based only on costs, they should choose the more cost-efficient option when there is more than one way to effectively treat a patient.