Everyone agrees that healthcare costs are running rampant. In fact, the Centers for Medicare & Medicaid Services reported that healthcare spending reached $3.4 trillion in 2016. Some professionals believe that a large percentage of these medical costs are due to the decisions physicians make for the care of their patients. While physicians must accept some of the blame, there are other factors that are contributing to the rise in medical spending. These include excessive hospital and administrative expenses, advances in medical technology, increases in chronic diseases exhibited by patients and a flawed healthcare insurance reimbursement system.
Many of the issues affecting healthcare costs are out of the control of physicians. Still there is a perception that some medical care choices made by physicians result in unnecessary procedures, tests and prescriptions. There are several reasons for some of these potentially redundant or unwarranted decisions. Physicians may order more tests or prescribe additional prescriptions to quickly uncover or rule out a diagnosis or to satisfy patients’ requests. They may be practicing defensive medicine out of fear of litigation or even to increase reimbursement rates. Now, as a method of controlling costs, many of these medical care options are being taken out of the hands of physicians and instead are dictated by insurance reviewers. Additionally, healthcare insurance companies continue to modify reimbursement rates for physicians’ services without considering the medical effectiveness of the prescribed treatments. It’s important to reduce services that aren’t adding value or improving patient outcomes. Yet, while controlling medical costs is important, there are concerns that patients are at risk of being denied essential treatment. Treating patients while keeping an eye on medical care costs is a balancing act.
Strategies to reduce medical costs
The good news is: it is possible to ensure that patients receive vital medical care without overextending medical resources. And, it’s also possible to discourage unnecessary and inappropriate medical services without jeopardizing essential, high-quality care. Here are some steps physicians can take to contain medical costs:
- Eliminate ordering daily labs, unless required by the patient’s medical condition.
- Avoid unnecessary imaging studies or repeating imaging studies without clear indication.
- Review the medical devices used and determine if there are more efficient or less expensive alternatives.
- Prescribe antibiotics only when medically required and based on appropriate culture results and medical conditions.
- Encourage shared decision making with patients.
- Use ancillary services, including physical therapy and occupational therapy, to promote early patient discharge.
- Promote wellness and prevention programs and support patients’ responsibilities to replace unhealthy behaviors with healthier choices.
- Practice evidence-based medicine instead of defensive medicine.
- Develop relationships with other health care providers working with the same patient(s). Strive to improve communication regarding treatment plans and reducing hospital readmissions.
- Refer patients to outpatient dedicated clinics such as those for anticoagulation, congestive heart failure and strokes.
- Teach patients to recognize the signs and symptoms of exacerbating conditions and to call their physicians immediately.
- Schedule registered nurses to visit patients, discharged from the hospital with certain conditions like CHF or COPD, at their homes for monitoring and to prevent hospital readmissions.
- Provide nutritional and dietary education to patients, tailored for their chronic diseases.
A physician’s job is to provide the best possible medical care to improve health outcomes for patients. Medical care is most successful when it is centered around patients and their outcomes. By ensuring that this medical care is essential, effective and not duplicating other services and treatments, physicians can do their part to reduce healthcare costs.
About the Author:
Madhukar Kasarla, M.D., works as a hospitalist physician with APOGEE Physicians at Parkway Surgical and Cardiovascular Hospital in Fort Worth, Texas. He also works for Texas Health Physicians Group at Texas Health Harris Methodist Hospital and Health Harris Methodist Hospital Southwest in Fort Worth, and Texas Health Harris Methodist Hospital in Azle, Texas. He did his Internal Medicine residency at Mercy Hospital & Medical Center, Chicago. For more information, please contact [email protected]; [email protected].