The cost of health care services greatly influences clinical decision making and subsequent outcomes, particularly when high costs prevent patients from following recommended treatment. To ensure the best possible care that meets patients’ needs, providers, health organizations, and patients must be able to share and receive information about health care costs and related financial constraints. This issue is especially relevant for essential hospitals that care for vulnerable patient populations, many of whom are under- or uninsured and face other financial hardships. Evidence-driven tools and resources can help essential hospitals recognize, understand, and engage in cost of care conversations with patients and families.
Essential Hospitals Institute is pleased to promote communication about health care costs with all patients, including vulnerable patients facing social, linguistic, and economic obstacles. The resources featured here were developed by a diverse set of stakeholders. Support for this project was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.
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Motivation/Initiation | Provider Training Modules | Provider Tools | Organizational Tools | Patient Tools | Practice Briefs
Motivation/Initiation
Learn more about why cost of care conversations are so crucial to high-quality, equitable health care.
This article, provided by Avalere Health, explores measurement concepts to improve and facilitate physicians and patients to embrace conversations regarding cost in the clinical setting through COVID-19.
This presentation provided by the Migrant Clinicians Network offers a brief introduction on cost-of-care conversations for providers by exploring the various elements influencing and involved in these conversations with patients.
This webinar includes a presentation on the role of cost of care conversations in clinical encounters, an overview of RWJF-funded research on Cost of Care Conversations and shared how the resulting evidence-based tools and resources can guide these important conversations.
This mixed-methods study uses interviews and a survey to understand the factors that influence physicians to discuss and consider cost during a patient encounter.
This observational study examines whether and how cost-of-care conversations occur in primary care encounters specifically in settings that provide care to vulnerable patients.
This podcast (the first of four) from Avalere Health focuses on how and why clinicians and other care team members can improve the quality and frequency of cost-of-care conversations.
This informational video from the Sinai Urban Health Institute and UIC Institute for Healthcare Delivery Design summarizes their research around the cost of prenatal care, including patient interviews.
This Practice Brief from Avalere provides you with information and data points to create buy-in among your peers and your organization’s leadership on the importance of cost-of-care (CoC) conversations.
This podcast (the first of four) from Avalere Health focuses on how and why clinicians and other care team members can improve the quality and frequency of cost-of-care conversations.
Provider Training Modules
These training resources help providers understand the “why” and “how” of talking to patients about cost.
This article by the University of Rochester discusses a practical approach to screening and managing patients’ cost-related medication concerns.
This webinar provided by the University of Rochester in collaboration with the National Research Network, provides team-based approach training for providers to implement and increase conversations around the cost of medication.
This provider training manual, developed by the Migrant Clinicians Network, explores culturally relevant tools for patients in a staff training that enables proactive exploration of cost concerns and integrates principles of shared decision-making and patient-centered care.
This study conducted focus groups and a point-of-care survey to develop and evaluate community-designed messages promoting cost-of-care conversations.
This qualitative study explores the perspectives of patients and cancer center staff to provide guidance for having sensitive cost-of-care conversations with patients diagnosed with cancer.
Medications contribute to patients’ out-of-pocket costs, yet most clinicians do not routinely screen patients for medication cost concerns.
This infographic, developed by Avalere Health, outlines 6 key priority areas for improving cost-of-care conversations between patients and clinicians, based on interviews with dozens of experts, including: patient advocates, clinicians, payers, organizations focused on shared decision-making and transparency, and academic researchers.
This presentation (offered in English and Spanish) from Migrant Clinicians Network provides user-friendly definitions for terminology used in cost-of-care conversations among doctors and patients.
This Practice Brief from Avalere provides you with actionable tips and simple frameworks for how to structure cost-of-care (CoC) conversations.
This Practice Brief from Avalere provides you with important considerations and study findings on facilitating cost-of-care (CoC) conversations with vulnerable patients.
Provider Tools
These tangible tools guide providers and their clinical staff during cost conversations with patients.
This action-planning guide from Kaiser Permanente Washington Health Research Institute walks you through a framework for cost conversations in the clinical setting. It describes three patient scenarios, suggestions for the conversations, and resources to help make the conversations part of routine care.
This tool was developed by the University of Rochester to aid providers in capturing, organizing, and evaluating baseline data from surveys including insurance type, prescriptions, and costs.
This presentation (offered in Spanish) by the Migrant Clinicians Network guides clinic staff through policies to improve cost of care conversations with patients.
This resource created by the Migrant Clinicians Network serves as a readiness questionnaire to assess what policies would aid health center staff in engaging in cost of care conversations with patients.
This podcast (the second of four) from Avalere Health focuses on why clinicians should speak with their patients about expected costs of their care and provides actionable tips for how to structure those cost-of-care conversations with patients.
This podcast (the third of four) from Avalere Health provides actionable pathways for clinicians to integrate cost-of-care conversations into the clinical workflow.
This podcast (the fourth of four) from Avalere Health delivers recommendations for overcoming barriers to implementing cost-of-care conversations into the clinical setting.
This webinar includes a presentation on “A Team-based Approach to Integrating Cost-of-Medication Conversations into Primary Care,” tips for structuring cost conversations, and important considerations for vulnerable patients.
This webinar includes a presentation on “5 Tips on How to Talk to Patients” and “Cost of Care Conversations Guide.”
This study developed a framework and tool to assist in cost-of-care conversations with low-income patients during prenatal care.
This article examines 8 studies to collect evidence for best practices and proposes 7 highly effective habits physicians can develop to talk with their patients about cost of care.
This pocket card from the University of Rochester gives providers sample questions to ask patients in regard to their cost of care.
These conversation guides from University of Southern Maine provide tailored support for providers, medical assistants, and front desk representatives to help support cost of care conversations.
This guide from Consumers Union gives providers quick tips for discussing out-of-pocket costs with patients.
This Practice Brief from Avalere provides actionable tips for addressing the potential barriers and challenges related to implementing cost-of-care (CoC) conversations in the clinical setting.
Organizational Tools
Organizational decision-makers can consider systematic improvements to their institution’s approach to cost conversations.
This toolkit was created to assist health systems in: supporting healthcare personnel in recognizing opportunities for cost conversations; responding to cost questions; and/or redirecting and referring cost questions to the appropriate health system personnel. The toolkit was produced by the American Board of Internal Medicine Foundation Choosing Wisely Initiative (Kelly Rand, MA, CPH), Health Engagements Strategies (Beccah Rothschild, MPA), and Susan Perez, PhD, MPH.
This webinar includes a presentation on a policy statement and procedure for effective cost of care conversations and how a Consumers Union survey can help hospital leadership ask providers about cost of care practices, actions, and conversations with patients.
This qualitative, human-centered design study sought to understand and improve clinical workflows related to cost-of-care conversations
This resource evaluates tools to facilitate the use of publicly available cost information during clinical visits for low back pain (LBP).
This template policy statement (in English and Spanish) from Migrant Clinicians Network outlines procedures for implementing and monitoring effective cost-of-care conversations in the practice setting.
This step-by-step workflow diagram from the University of Southern Maine helps staff and providers incorporate cost conversations about low back pain treatment into an applicable patient visit.
These four University of Rochester newsletters highlight important information and results from their cost of medication conversations study team.
This guide from Consumers Union gives providers quick tips for discussing out-of-pocket costs with patients.
This Practice Brief from Avalere provides you with concrete suggestions for how to welcome cost-of-care (CoC) conversations in your practice and “ready to use” examples to do so.
This Practice Brief from Avalere provides you with key considerations for constructing workflow modifications to support cost-of-care (CoC) conversations in your organization.
Patient Tools
This collection of tools arms patients with key questions and considerations for discussing the cost of care with health care providers and staff.
This brochure (offered in English and Spanish) from the Migrant Clinicians Network provides a graphical breakdown of how health insurance typically works.
This brochure (offered in English and Spanish) from the Migrant Clinicians Network provides definitions of common health insurance terms to aid cost of care conversations with patients.
This webinar included a presentation on a tool that helps patients anticipate the indirect costs of prenatal care and posters developed alongside patients and staff at community health clinics to support cost of care conversations.
These sample posters from University of Rochester encourage patients to talk with providers and offer tips for dealing with medication costs.
This cost conversation tool from Sinai Urban Health Institute and the UIC Institute for Healthcare Delivery Design helps providers and patients anticipate the indirect costs of prenatal care.
This poster (available in Spanish and English), was developed by the Center for Health Progress in collaboration with patients and staff at a community health worker program to encourage patients to discuss costs with their clinicians.
This flier (available in Spanish and English), was developed by the Center for Health Progress in collaboration with patients and staff at a family community health clinic to support cost of care conversations.
Practice Briefs
As part of the Cost Conversation projects, Avalere worked closely with the Robert Wood Johnson Foundation project grantees to synthesize the key themes and findings across their exploratory studies and create a series of Practice Briefs. These briefs are intended to act as actionable resources to clinicians, staff, and practice administrators interested in increasing the value and frequency of cost-of-care conversations in the clinical setting. The briefs cover the key topics below.
This issue brief, provided by Avalere Health, highlights the challenges associated with measurement in payment incentives alongside alternative solutions to encourage cost of care conversations in practice.
This Practice Brief provides you with information and data points to create buy-in among your peers and your organization’s leadership on the importance of cost-of-care (CoC) conversations.
This Practice Brief provides you with concrete suggestions for how to welcome cost-of-care (CoC) conversations in your practice and “ready to use” examples to do so.
This Practice Brief provides you with actionable tips and simple frameworks for how to structure cost-of-care (CoC) conversations.
This Practice Brief provides you with important considerations and study findings on facilitating cost-of-care (CoC) conversations with vulnerable patients.