Using Public Cost Information During Low Back Pain Visits: A Qualitative Study.

Area of Science:

• Health Services Research
• Health Informatics
• Patient Engagement

Background:

• Patients increasingly bear healthcare costs and seek cost information.
• Publicly available cost data can facilitate provider-patient cost discussions during clinical visits.
• Low back pain (LBP) care costs are a significant concern for patients.

Purpose of the Study:

• To evaluate tools designed to integrate publicly available cost information into clinical visits for LBP care.
• To assess the feasibility and impact of using cost transparency tools in primary care settings.
• To understand provider and patient perspectives on discussing healthcare costs at the point of care.

Main Methods:

• A qualitative study involving 6 rural primary care practices in Maine.
• Intervention included financial incentives, training, and technical assistance for using CompareMaine.org.
• Data collection via individual and group interviews and surveys with practice staff (n=50) and patients with LBP (n=72).

Main Results:

• Provider and patient awareness of CompareMaine.org increased, but tool use in clinical discussions was minimal.
• Workflow barriers, limited system support, and provider reluctance hindered tool adoption.
• Patients found cost conversations valuable and intended to use cost tools for future decisions, despite low provider uptake.

Conclusions:

• A multicomponent intervention to introduce cost information into LBP care discussions had low provider adoption.
• Patients perceived cost conversations and transparency tools as useful, but providers were hesitant to discuss cost variations.
• Successful integration of public cost information requires normalizing its use and enhancing provider and health system engagement.