Achieving greater value for veterans through full cost transparency in primary care.

Autor: Agbafe VC; University of Michigan Medical School, Ann Arbor, MI, USA., Metzger N; Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA., Garlick BR; Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA., Caverly T; Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA; Department of Internal Medicine, School of Medicine, University of Michigan, Ann Arbor, USA; Institute for Health Policy and Innovation, University of Michigan, Ann Arbor, USA; Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, USA., Saini S; Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA; Department of Internal Medicine, School of Medicine, University of Michigan, Ann Arbor, USA; Institute for Health Policy and Innovation, University of Michigan, Ann Arbor, USA; Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, USA., Kerr E; Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA; Department of Internal Medicine, School of Medicine, University of Michigan, Ann Arbor, USA; Institute for Health Policy and Innovation, University of Michigan, Ann Arbor, USA; Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, USA., Matloub S; Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA., Kullgren JT; Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA; Department of Internal Medicine, School of Medicine, University of Michigan, Ann Arbor, USA; Institute for Health Policy and Innovation, University of Michigan, Ann Arbor, USA; Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, USA. Electronic address: jkullgre@med.umich.edu.
Jazyk: angličtina
Zdroj: Healthcare (Amsterdam, Netherlands) [Healthc (Amst)] 2023 Jun; Vol. 11 (2), pp. 100687. Date of Electronic Publication: 2023 Mar 02.
DOI: 10.1016/j.hjdsi.2023.100687
Abstrakt: The COVID-19 pandemic has led to increased use of telephone and video encounters in the Veterans Health Administration and many other healthcare systems. One important difference between these virtual modalities and traditional face-to-face encounters is the different cost-sharing, travel costs, and time costs that patients face. Making the full costs of different visit modalities transparent to patients and their clinicians can help patients obtain greater value from their primary care encounters. From April 6, 2020 to September 30, 2021 the VA waived all copayments for Veterans receiving care from the VA, but since this policy was temporary it is important that Veterans receive personalized information about their expected costs so they can obtain the most value from their primary care encounters. To test the feasibility, acceptability, and preliminary effectiveness of this approach, our team conducted a 12 week pilot project at the VA Ann Arbor Healthcare System from June-August 2021 in which we made personalized estimates of out-of-pocket, travel, and time costs available and transparent to patients and clinicians in advance of scheduled encounters and at the point of care. We found that it was feasible to generate and deliver personalized cost estimates in advance of visits, that this information was acceptable to patients, and that patients who used cost estimates during a visit with a clinician found this information helpful and would want to receive it again in the future. To achieve greater value in healthcare, systems must continue to pursue new ways to provide transparent information and needed support to patients and clinicians. This means ensuring clinical visits provide the highest levels of access, convenience, and return on patients' healthcare-associated spending while minimizing financial toxicity.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Jeffrey Kullgren reports a relationship with SeeChange Health that includes: consulting or advisory. Jeffrey Kullgren reports a relationship with HealthMine that includes: consulting or advisory. Jeffrey Kullgren reports a relationship with Kaiser Permanente Washington Health Research Institute that includes: consulting or advisory. Jeffrey Kullgren reports a relationship with Donaghue Foundation that includes: consulting or advisory. Jeffrey Kullgren reports a relationship with AbilTo that includes: consulting or advisory. Jeffrey Kullgren reports a relationship with Kansas City Area Life Sciences Institute Inc that includes: consulting or advisory. Jeffrey Kullgren reports a relationship with American Diabetes Association that includes: consulting or advisory. Victor Agbafe reports a relationship with Third Culture Capital that includes: consulting or advisory.
(Copyright © 2023. Published by Elsevier Inc.)
Databáze: MEDLINE
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