Who Should be Held Accountable for Healthcare Costs?

Updated: Jul 26, 2018

About one-half of healthcare leaders and clinicians said providers are not accountable for total cost of care, but payers and pharmaceutical companies are, a new survey found.


Who Should be Held Accountable for Healthcare Costs?” was recently published in Practice Management News and it contains a survey of healthcare providers that gets to the crux of the problem:

  • Only 28% of clinicians believe they have a “strong” impact on the cost of care, despite the fact that their compensation plus their ordering authority clearly account for the majority of healthcare costs.

  • And 90% of clinicians find healthcare costs to be confusing and 86% report that they lack the skill set to discuss healthcare costs with patients.

Has there ever been a more clear cost control perfect storm? The primary cost controller denies understanding healthcare costs and even worse disowns their role in the cost of care.

Of course, insurers, governments, employers and the public are all complicit, but we'll save that for another time. - Sanders DiPiero


July 16, 2018 - While the recent growth in patient financial responsibility has providers thinking about healthcare costs when making care decisions, many still do not think they should be held accountable for the costs of care, a recent survey showed.


A new NEJM Catalyst Buzz Survey, sponsored by the University of Utah Health, asked the NEJM Catalyst Insights Council, a qualified group of healthcare executives, clinical leaders, and clinicians, about their views on healthcare costs and patient financial responsibility.


Respondents unanimously agreed that out-of-pocket costs are important to patients, and the majority said that when making clinical decisions, they consider the cost to the practice or health system (76 percent of respondents), out-of-pocket costs (72 percent), and total cost of care (68 percent).


Chart shows most healthcare leaders and clinicians consider healthcare costs and patient financial responsibility while deciding on patient treatment options.

Source: University of Utah Health and NEJM Catalyst


Over 60 percent of the physicians also reported that they are responsible for educating their patients about healthcare costs.


However, almost one-half of the respondents said they should not be held accountable for total cost of care.


READ MORE: Key Ways to Boost Collection of Patient Financial Responsibility


Clinicians were the most likely to believe they were not accountable for healthcare costs, with 53 percent, followed by clinical leaders with 44 percent and healthcare executives with 32 percent.


“Physicians should definitely be aware of the charges generated by the treatments or prescriptions they recommend,” Mark Melrose, DO, Chief of Emergency Services at NYC Health + Hospitals’ North Central Bronx Hospital, stated in the survey report. “Maybe they aren’t responsible for the actual cost, but they should be aware of the way they are contributing to the cost of care to a patient.”


Instead, respondents pointed their fingers at payers. Eighty-one percent said that payers, health plans, and HMOs had the strongest impact on cost of care, coming in second behind pharmaceutical and biotech companies.


About three-quarters of the participants also found hospitals, health systems, and physician organizations as having the greatest impact on healthcare costs.


READ MORE: https://revcycleintelligence.com/news/who-should-be-held-accountable-for-healthcare-costs

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