Study: Doctors Look To Others To Play Biggest Role In Curbing Health Costs

When it comes to controlling the country’s health care costs, doctors point their fingers at lawyers, insurance companies, drug makers and hospitals. But well over half acknowledge they have at least some responsibility as stewards of health care resources.

In a study, published in the Journal of the American Medical Association, Mayo Clinic researchers surveyed more than 2,500 doctors to assess their views of different approaches to rein in the nation’s health care costs. The doctors were randomly selected from an American Medical Association database.

Based on the findings, 59 percent of doctors believe they have some responsibility in holding down health care costs. Only 36 percent think they have a major role. More than half of doctors, however, said each of five other groups carry “major responsibility:” trial lawyers, health insurance companies, pharmaceutical companies, hospitals and patients.

When asked about options to reduce health care costs, most doctors viewed efforts to improve the quality and efficiency of care most favorably. For example, 98 percent are enthusiastic about efforts to promote care coordination for people with chronic diseases. Doctors were also mostly in favor of improving conditions for evidence-based decisions, including efforts to prevent corporate influence of physicians’ decisions and promoting head-to-head trials of competing treatments. They were less enthusiastic about changing current payment models. Only 7 percent, for example, were very enthusiastic about eliminating the traditional fee-for-service payment system, while another 23 percent were somewhat enthusiastic. About a third of the physicians expressed enthusiasm for bundled payment systems.

New Study Finds Better Doctor-Patient Relationships Leads to Better Medication Adherence

A new study published in JAMA Internal Medicine finds that physicians can improve medication adherence by cultivating better relationships with patients. Researchers looked at 9,377 patients taking medications to lower their blood sugar, blood pressure, or cholesterol. Adherence was determined by measuring delays in refilling prescriptions. Patients who felt their doctors listened to them, had involved them in decisions and gained their trust followed doctors' orders more often and took their drugs as prescribed. Patients who gave their doctors poor marks in communicating were less likely to adhere to their medications. The study's authors note that future studies should investigate whether improving communication skills among clinicians with poorer patient communication ratings could improve their patients' cardiometabolic medication refill adherence and outcomes. This study indicates there is a strong motivation for employers as payers to take an active role in improving the doctor-patient relationship because such improvements have the potential for long-term cost savings through better medication - and potentially other treatment - adherence.

Study: New Medical Care Networks Show Savings

The New York Times reported that a new model for delivering medical care, one promoted by the federal health care law, holds promise for slowing the cost of treating the sickest, most expensive patients, according to a new study.

"The study, published last week in the The Journal of the American Medical Association, found that a predecessor to accountable care organizations achieved particular savings in caring for patients eligible for both Medicare and Medicaid.

Many of those patients have multiple, severe health conditions and are especially expensive: The nation’s nine million “dual eligibles,” as they are known, make up 15 percent of the Medicaid population but account for 39 percent of the program’s spending.

In the predecessor program, a Medicare experiment that ran from 2005 to 2010, 10 doctors groups from around the country received bonus payments if they met quality targets and achieved lower cost growth compared with Medicare spending on other patients in their region.

The study, conducted by researchers from the Dartmouth Institute for Health Policy and Clinical Practice, found that the growth in spending per “dual eligible” patient slowed by $532 a year, or 5 percent, after doctors groups joined the demonstration program."