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Study: Transparent pricing doesn't curb doctors' use of high-cost hospital imaging tests
Date:1/23/2013

In a study designed to see if doctors who are told the exact price of expensive medical tests like MRIs in advance would order fewer of them, Johns Hopkins researchers got their answer: No.

In a report published online in the Journal of the American College of Radiology, the researchers found that revealing the costs of MRIs and other imaging tests up front had no impact on the number of tests doctors ordered for their hospitalized patients.

"Cost alone does not seem to be the determining factor in deciding to go ahead with an expensive radiographic test," says the study's senior author, Daniel J. Brotman, M.D., an associate professor of medicine at the Johns Hopkins University School of Medicine and director of the hospitalist program at The Johns Hopkins Hospital. "There is definitely an over-ordering of tests in this country, and we can make better decisions about whether our patients truly need each test we order for them. But when it comes to big-ticket tests like MRI, it appears the doctors have already decided they need to know the information, regardless of the cost of the test."

Studies in the past suggest that much of the expense of laboratory tests, medical imaging and prescription drugs is unknown or hidden from providers and patients at the time of ordering, leaving financial considerations largely out of the health care decision-making process and likely driving up costs, Brotman notes.

Other studies have shown that doctors ordered fewer laboratory tests in some cases when they were given the price up front. But Brotman says imaging tests appear to be "a different animal."

There are built-in disincentives to ordering many major tests if they are not necessary, such as the potential danger of radiation used in some, Brotman says. In addition to making physicians more sensitive to the costliness of unnecessary testing, Brotman says they need to learn how to explain to patients why they may not need
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Contact: Stephanie Desmon
sdesmon1@jhmi.edu
410-955-8665
Johns Hopkins Medicine
Source:Eurekalert

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