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Talking Costs - How to Help Patients Afford Their Care

Oct 27, 2016

Physicians are trained to make treatment decisions that are in the best interest of their patients’ health – not what patients can afford or what the insurance company will pay. Yet that thinking can easily backfire, resulting in noncompliant patients who have to cut corners to afford their care.

Skipping follow-up care, cutting pills in half to make them last longer or stopping their drug regimen altogether are all-too-common patient stories.

Start the Conversation

Many physician advocates and medical societies agree that discussing costs and options can lead to cost savings for patients without lessening the quality of care. Problem is, physicians aren't trained to discuss cost barriers and may feel it's inappropriate to bring up money at all. Even if they do, they may find it a challenge to shoe horn the discussion into a 15-minute visit.

A good way to start the conversation is by asking a few questions on the patient intake form. Ask patients to let you know about any concerns with costs or if they are experiencing difficulty paying past medical bills. Then, follow up in the exam room.

The goal is to bring patients into the decision-making process. For example, something as simple as prescribing a 90-day supply of medicine can help reduce out-of-pocket costs for medications. The timing of tests or procedures can also have a big impact. For example, talk with patients about scheduling expensive tests later in the year when their annual deductibles are more likely to have been met.

Don’t Dismiss Patient Concerns

With patients increasingly responsible for more of their own health costs, physicians have a role in helping patients find appropriate and affordable care. A good resource is the ABIM Foundation’s Choosing Wisely® initiative (, which provides hundreds of cost-effective options based on medical subspecialty and diagnosis. These range from drugs and tests to maintenance supplies and more.

Far from “contaminating” the doctor-patient relationship, discussing costs and options with patients may very well strengthen it.

Healthcare Practice Strategies - Fall 2016

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