Fee Data May Deter Docs From Ordering Labs

Charles Bankhead | MedPage Today | April 15, 2013

Displaying the cost of a test to providers at the time of ordering led to a modest decrease in the number of orders for laboratory studies placed over a 6-month period, investigators reported.

As compared with a 6-month period when test costs were not displayed, total test volume declined by almost 9%, reported Leonard Feldman, MD, of Johns Hopkins University School of Medicine, and colleagues online in JAMA Internal Medicine.

In contrast, test-order volume increased by almost 6% in a control group of providers who never saw the cost of a test before ordering, they said.

"Displaying the Medicare allowable fees of diagnostic tests at the time of ordering can modestly affect provider ordering behavior," Feldman's group wrote. "Whether broadening this intervention and coupling it with educational interventions related to cost consciousness and stewardship of resources will increase its effect on clinical practice deserves further study, provided that providers are not inappropriately incentivized to limit needed care."