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Kevin Wilkerson

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Jul 10, 2018 8:00 AM

When it comes to high health care costs, physicians are clear they are not the ones to blame and instead pinpoint pharmaceutical and insurance companies, according to a new survey from University of Utah Health.

U of U Health surveyed members of the NEJM Catalyst Insights Council, who are clinicians, clinical leaders and health care executives involved with health care delivery. The survey found that most of the 571 respondents (72 percent of whom are physicians) overwhelmingly believe pharmaceutical firms, followed closely by insurance companies, hospitals and health systems, have the biggest impact on costs.

A full 87 percent of those surveyed listed pharmaceutical/biotech companies as having the biggest impact on the cost of health care, followed by health plans/HMOs/insurers at 81 percent, and hospitals/health systems/physician organizations at 75 percent. Only 30 percent said that individual clinicians have a strong impact on the cost of health care. Respondents indicated patients have the least effect on cost.

“This survey shows that doctors do care about medical costs and are sensitive to those costs,” said Robert Glasgow, MD, a surgeon with University of Utah Health. For example, 73 percent of respondents indicated that the out-of-pocket cost to the patient enters into their clinical decisions, However, only 30 percent of physicians agree that they should be held accountable for the cost of care to a patient. “Physicians don’t set up pricing for insurance and we can’t determine the price of a drug or new technology,” Glasgow added. “So it’s easy to feel powerless when it comes to impacting costs.”

Other revealing parts of the survey showed that 86 percent believe physicians are not adequately trained to even discuss the cost of care and 64 percent say there is not enough time to discuss the costs of treatments with patients.  Furthermore, 90 percent of those surveyed believe that health care costs are too confusing for patients and 78 percent feel the necessary tools are not available for patients to estimate health care costs.

“The people who are paying for health care, delivering heath care and receiving health benefits should have more power,” Glasgow noted. “They should be the ones to start the discussion and begin to influence the cost structure.”

In an ideal state, all stakeholders would be accountable for costs in the broader context of delivering high-value health care,” added Glasgow, “where the highest quality care is delivered in the most cost-effective fashion.”

The full survey is available online on NEJM Catalyst: catalyst.nejm.org.

The survey was conducted by NEJM Catalyst, as part of the NEJM Catalyst Insights Council. The council is a qualified group of U.S. executives, clinical leaders and clinicians at organizations directly involved in health care delivery. 

The margin of error for a base of 571 in a survey is +/-4.1 at the 95 percent confidence level.

University of Utah Health is the Mountain West's only academic health care system, combining excellence in patient care, the latest in medical research, and teaching to provide leading-edge medicine in a caring and personal setting.

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