The cost of health care services significantly influences patients’ decision making when selecting care and can affect subsequent health outcomes. Approximately 20 percent of patients report forgoing care when they have questions about costs, research from the Robert Wood Johnson Foundation (RWJF) shows.

Essential hospital leaders are acutely aware of these concerns among their vulnerable patient populations, many of whom are under- or uninsured. To help patients and providers have conversations about the cost of care, America’s Essential Hospitals has shared tools produced by eight RWJF grantees in an online resource library at

Building on the original RWJF-funded research, the Essential Hospitals Institute — the association’s research, dissemination, education, and leadership development arm — leveraged RWJF support to award six additional minigrants to Cost of Care Conversations grantees. These six-month minigrants enabled grantees to expand upon, refine, or disseminate their earlier work.

The tools produced through the minigrants, now available in the online resource library, include trainings and resources to help providers, patients, and health care organizations engage in cost of care conversations and reduce cost concerns when patients select care.

Minigrantees produced the following resources:

Migrant Clinicians Network

Improving Patient Adherence with Cost of Care Conversations presentation offers a brief introduction on cost-of-care conversations for providers by exploring the elements that influence conversations with patients.

Clear on The Cost: Patients and Providers Co-Authoring the Care Plans manual explores culturally relevant patient tools in a staff training that proactively explores cost concerns and integrates principles of shared decision-making and patient-centered care.

Readiness Questionnaire assesses what policies would aid health center staff in engaging in cost of care conversations with patients.

How “Typical” Health Insurance Works brochure (offered in English and Spanish) provides a graphical breakdown of how health insurance typically works.

Policy Statement and Procedure for Effective Conversations About the Costs of Health Services presentation guides clinic staff through policies to improve cost of care conversations with patients.

What Do the Terms in Health Insurance Mean for Patients’ Cost of Care? brochure (offered in English and Spanish) defines common health insurance terms to aid cost of care conversations with patients.

University of Rochester

A Team-based Approach to Integrating Cost-of-Medication Conversations into Primary Care trains providers to initiate and increase conversations about the cost of medication.

Data Comparison Tool aids providers in capturing, organizing, and evaluating baseline survey data, including insurance type, prescriptions, and costs.

A Practical Approach to Reducing Patients’ Prescription Costs discusses a pragmatic approach to screening and managing patients’ cost-related medication concerns.

Kaiser Permanente Washington Health Research Institute

A Guide to Address Patients’ Concerns About Costs of Care walks clinicians through a framework for cost conversations by describing three patient scenarios, providing suggestions for the conversations, and sharing resources to help make the conversations part of routine care. 

American Board of Internal Medicine Foundation Choosing Wisely, Health Engagement Strategies, and Susan Perez

Right Question, Wrong Person: A Toolkit to Facilitate Cost-of-Care Questions in Health Systems helps health systems support staff in recognizing opportunities for cost conversations, responding to cost questions, and referring cost questions to the appropriate health system personnel.

North Carolina Eastern Area Health Education Center

Adding It Up: Diabetes Care + Cost interactive tool outlines action steps for patients diagnosed with diabetes and aids in accounting for and calculating monthly medication cost.

For these and additional tools and resources, visit America’s Essential Hospitals’ Cost of Care Conversations resource library at