Key Steps to Improve Patient-Clinician Cost-of-Care Conversations

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With growing out-of-pocket spending for care, patients are increasingly interested in knowing, upfront, how much their care will cost them, and how it relates to the quality and appropriateness of their care. Yet, various barriers often prevent these conversations from occurring during routine clinical encounters.
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On behalf of the Robert Wood Johnson Foundation, we have conducted research on the barriers encountered around patient-clinician cost-of-care conversations. One specific focus of our research was how to support vulnerable and marginalized populations in these conversations. We spoke to dozens of experts representing all groups of interest, and identified the following six broad priority areas for improving these conversations:

  • Improving education and engagement on cost-of-care conversations, for both patients and clinicians
  • Developing robust cost-of-care tools for use at the point of care
  • Ensuring cost conversations are embedded in the clinical workflow
  • Providing training and resources on cost communication strategies
  • Measuring the effectiveness of cost conversations
  • Scaling successful initiatives beyond the local level

We then crowdsourced these priority areas, as represented in the below infographic, for public input and feedback. We received dozens of insightful responses, mainly from patients/patient advocates and clinicians, as well as some other stakeholders such as payers and health data transparency organizations.

Based on what we have learned through this process, we will now work with RWJF in identifying next steps to support projects for the development of tangible, usable tools, strategies, infrastructure, and/or accompanying research that will facilitate cost-of-care conversations between patients and clinicians at the point of care.

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