Provider cost transparency does not influence number of imaging tests ordered

Johns Hopkins researchers found that informing providers of the cost of MRIs and other imaging tests up front had no bearing on the number of tests they ordered for their patients.

“Cost alone does not seem to be the determining factor in deciding to go ahead with an expensive radiographic test,” Daniel J. Brotman, MD, lead author and associate professor of medicine at the Johns Hopkins University School of Medicine, stated in a press release. “There is definitely an over-ordering of tests in this country, and we can make better decisions about whether our patients truly need each test we order for them. But when it comes to big-ticket tests like MRI, it appears the doctors have already decided they need to know the information, regardless of the cost of the test.”

For a 6-month period, Brotman and colleagues showed prices to surgeons for the 10 most common imaging tests to one test group, while a control group was not shown costs for the tests they ordered. After comparing the number of tests ordered to the number ordered a year prior, they found that there was no significant difference in the amount of tests ordered.

Brotman said that while showing physicians the cost of imaging tests may not have affected their decision-making, cost transparency as a whole could help lower the number of expensive tests ordered.

“Cost transparency must be part of the solution to solving fiscal challenges in medicine,” he said. “Providers have no idea how much they’re spending. Patients don’t know either. Having everyone understand more of the economics of health care is a great place to start cutting costs in medicine.”

Reference:

Durand DJ. J Am Coll Radiol. 2013;doi:10.1016/j.jacr.2012.06.020.

Disclosure: The authors received research support from the Research & Education Foundation of the Radiological Society of North America, the Walter and Mary Ciceric Research Award and the Johns Hopkins Hospitalist Scholars Program.