Lowering Health Care Costs: Some Benevolent Geniuses Are On It

This Cost Conversations in Healthcare conference I was invited to address, put on by dedicated people from the ABIM Foundation, Robert Wood Johnson, and Costs of Care, has been fascinating. Just being in the room where it happens, the room filled with smart people who are bent on making it happen, was worth coming down to Philly for.

It turns out medical professionals and other smart folks with resources really are trying to shift the status quo. They’re even making progress.

Some of the change-in-progress I’ve been able to see first-hand. Check this out, for example.

Excited to share GOTMeDS module at cost conversations “Showcase of Tools” today #costsofcare @CostsofCarepic.twitter.com/wBRORyTTch

— Vinny Arora MD (@FutureDocs) December 3, 2015

The University of Chicago’s Dr. Arora has been distributing these cards to doctors young and old, and they’ve been able to use them to make a real day-to-day difference. The cards keep practitioners aware that cost is a huge concern to many patients. Doctors who merely prescribe meds without any consideration of the financial impact are contravening their own rule “First do no harm.”

There are very often affordable alternatives to brand-name drugs, and something as simple as a laminated reminder can help a doctor make sure that her patient actually ends up filling a prescription — and then getting better.

A lot of doctors have a hard time even mentioning money. They’re Kate Winslet-y and squeamish about it. That’s understandable, considering how most of us can find the subject so thorny as to be unapproachable. But it’s even more important than it is thorny, as Jeanne Pinder of Clear Health Costs puts it, “in the era of $1,000-a-day medications and sky-high deductibles, when doctors’ recommendations are increasingly rejected by insurers and patients are left holding the bag.”

Clear Health Costs is another innovation I was able to see demoed. Acting on one of those ideas that’s so good it seems obvious in retrospect, it crowd-sources information from patients so that prospective patients can see the immense variability in price for the same procedure.

Maybe you already knew, on some level, that an MRI could set you back $400 in one place and probably much more somewhere else in the same city. This transparency tool lets you see exactly how much difference there can be in the same region — 3x the cost! — and then decide, “Man. Maybe I won’t go to Columbus Circle to get my scans done.”

Then there’s Dr. Neel Shah, founder of Costs of Care, who first invited me to join in on the fun and who is probably the next Atul Gawande. I can’t wait to see what he accomplishes next.

Thank you for your efforts, benevolent geniuses! It makes me feel better about the world to know you’re in it.


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