Primary-care physicians are not prepared to provide the financial information their patients with high-deductible, consumer-driven health plans and health savings accounts require, according to a new report in the October issue of the American Journal of Managed Care.
Of the 528 physicians who responded to a mail-in survey between May and June of 2007, only 48% said they were ready to discuss medical budgets with patients, 43% reported low knowledge of how such health plans work, and about one-third reported low knowledge of how health savings accounts function.
We were surprised by the number of physicians who said they didnt know enough to properly advise patients, said report co-author Craig Pollack, with the Robert Wood Johnson Clinical Scholars Program at the University of Pennsylvania.
Pollack added that the use of consumer-driven health plans has grown from 440,000 to 5.5 million in the last three years.
Initially, it was thought that it was the healthy and wealthy who signed up for these plans: people who could afford them and may not need a lot of medical care, Pollack said, but now high-deductible plans are increasingly becoming the only option for some patients and doctors need to get up to speed quickly on their patients out-of-pocket costs for medications, laboratory and radiology tests, specialist consultations, and hospitalizations.
According to the study, the issue is being complicated by physician mistrust of online quality reports that their patients rely on for information, and this has the potential to create tension in the physician-patient relationship.
Meanwhile, physicians may grapple with whether to recommend the most-effective care or the most-affordable care, the study concludes. Patients may be less likely to reach clinical milestones, with attendant negative effects on patient health and physician remuneration in the form of pay-for-performance reimbursements.
The study was funded by the Robert Wood Johnson Clinical Scholars Program. -- by Andis Robeznieks
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