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Price Transparency for Laboratory Tests Does Not Change Physician Ordering Behavior

A recent randomized clinical trial studied the effect of providing physicians the Medicare allowable fees for inpatient laboratory tests on their ordering behavior. The Pragmatic Randomized Introduction of Cost data through the electronic health record (PRICE) included 98,529 patients comprising 142,921 admissions at 3 Philadelphia hospitals between April 2014 and April 2016. Inpatient laboratory test groups were randomly assigned to either display or not display Medicare allowable fees in the electronic health record. The primary outcome was the number of tests ordered per patient day. Results were compared during a 1-year intervention to a 1-year preintervention period and were adjusted for patient demographics, insurance, disposition and comorbidity severity.

Displaying Medicare allowable fees for inpatient laboratory tests in the electronic health record at the time of ordering did not lead to a significant change in physician ordering behavior. I wonder if a different outcome would have been achieved if the authors had displayed hospital charges for inpatient lab tests, which may be up to 40 times higher than Medicare allowable fees?

Sedrak MS et al. JAMA Intern Med. doi:10.1001/jamainternmed.2017.1144

Published online April 21, 2017.

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