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Presenting Fee Data to Docs Cuts Number of Tests Ordered

Providing fee data at the time of test order correlates with a small reduction in tests ordered

WEDNESDAY, April 17 (HealthDay News) -- Presenting fee data to providers at the time of laboratory test orders is associated with a small reduction in the number of tests ordered, according to a study published online April 15 in JAMA Internal Medicine.

Leonard S. Feldman, M.D., from the Johns Hopkins University School of Medicine in Baltimore, and colleagues conducted a controlled clinical trial at a tertiary care hospital to examine whether presenting providers with test fees at the time of order could decrease the number of laboratory tests ordered. Sixty-one diagnostic laboratories were randomly assigned to an active arm (fee displayed) or control arm during a six-month intervention period, and the rates of test ordering were compared with those during a six-month baseline period.

The researchers observed an 8.59 percent decrease in the rates of test ordering in the active arm, from 3.72 tests per patient-day in the baseline period to 3.40 in the intervention period. In contrast, ordering increased 5.64 percent in the control arm, from 1.15 in the baseline period to 1.22 in the intervention period one year earlier.

"We conclude that displaying the Medicare allowable fees of diagnostic tests at the time of ordering can modestly affect provider ordering behavior," the authors write. "Whether broadening this intervention and coupling it with educational interventions related to cost consciousness and stewardship of resources will increase its effect on clinical practice deserves further study, provided that providers are not inappropriately incentivized to limit needed care."

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