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II. What are the Most Common Barriers to Implementing Cost-of-care Conversations

Tips for Addressing the Frequently Asked Questions

Primary sources: All eight grantees

“I didn’t know that I could say, ‘How much does it cost to come here?’ I didn’t know physicians had anything to do with the money part of it.” Patient, Consumer Reports study

“We recognized that our patients were having cost issues, but we didn’t appreciate the scope of the challenges that patients are facing.” Primary Care Physician, University of Rochester Medical Center study

Key Takeaways

  • Physicians cite lack of time, resources and knowledge of patient costs as barriers to having cost-of-care conversations. They also lack tools that can be used to integrate these conversations into the clinical workflow.
  • Administrators and leadership are reluctant to add anything to clinical encounters that slows the workflow and does demonstrably contribute to improvements in either patient or business outcomes.
  • Training, tools and resources tailored to each member of the care team work best and are most easily integrated into the clinical workflow.
  • Vulnerable populations face specific challenges related to barriers about discussing money or financial concerns with their doctors or fear that inability to pay for or access care will compromise the quality of their care.
  • Programs that provide training to all staff on when and how to have cost-of-care conversations are valuable and should include data sharing, patient stories and experiences, tools that can be used in clinical encounters and ways of assessing the value of these conversations.
  • Cost-of-care conversations can be linked to other key issues, including value-based payment initiatives and revenue cycle management.
  • Conversations about cost-of-care are a team effort and all staff should receive training and be involved in talking to patients about their financial concerns.
  • Training on specific issues that affect cost-of-care discussion with vulnerable populations is critical.