Paid Price Information on Image and Procedure Ordering Rates

NCT ID: NCT02611999

Last Updated: 2017-01-31

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

1205 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-01-31

Study Completion Date

2016-10-31

Brief Summary

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The investigators' study seeks to explore the impact of price information on physicians' ordering behavior and care quality. The investigators will evaluate the impact of the physician price transparency initiative at Atrius Health (ATRIUS) on rate of overall procedure and test orders, clinically inappropriate orders, and appropriate orders. Ultimately, this study will help stakeholders understand the degree to which price information can help improve the value of healthcare.

Detailed Description

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The investigators' study team worked with Atrius Health (ATRIUS) to design a physician price transparency (PPT) intervention aimed at providing primary and specialty care physicians with price information on commonly-ordered outpatient procedures (e.g., Pap smears, ECHOs, colonoscopies) and imaging tests (e.g., CTs and MRIs). The 2014 PPT intervention was built upon a pilot that ATRIUS conducted in 2010. Starting January 1, 2014, ATRIUS randomized its physicians to 3 different study arms, those receiving:

1. No price display for common outpatient procedures or imaging tests,
2. A single price for each procedure or test, or
3. A pair of prices for each procedure or test (that allowed physicians to compare prices that would be charged if the test was conducted at a facility within the ATRIUS network versus outside of it).

The mode for delivering this PPT intervention was ATRIUS' common electronic medical record (EMR), which all of its physicians use to place all orders related to outpatient procedures and imaging studies.

The investigators used a blocked randomized-controlled study design to quantitatively and qualitatively evaluate the effect of No, Single and Paired procedure and imaging test price information on: rate of overall procedure and test orders, clinically inappropriate orders, and appropriate orders.

The investigators used ATRIUS' administrative and EMR Data Repository to assess the quantitative outcomes proposed within this study. This repository contains the information the investigators need to block randomize at the practice level and to describe practices (e.g., size, location) and physicians (e.g., age, gender, specialty). It also captures all of the actions that physicians take when caring for patients (all orders are placed through their common EMR) and collects all of the information needed to assess clinical care quality using Healthcare Effectiveness Data and Information Set (HEDIS) measures. Data from this system have been used in numerous prior analyses of healthcare quality.

Conditions

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Healthy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

SINGLE

Investigators

Study Groups

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Control

Physicians in this Arm received only a paper memo with a list of common imaging tests and procedures.

Group Type NO_INTERVENTION

No interventions assigned to this group

Single Price

Physicians in this Arm received a single median price in the electronic medical record at the time of ordering in addition to the paper memo.

Group Type EXPERIMENTAL

Single median price information

Intervention Type BEHAVIORAL

Physicians in this Arm received a single median price in the electronic medical record at the time of ordering in addition to the paper memo.

Paired Inside/Outside Prices

Physicians in this Arm received two prices (the inside and outside price) in the electronic medical record at the time of ordering in addition to the paper memo.

Group Type EXPERIMENTAL

Paired inside/outside price information

Intervention Type BEHAVIORAL

Physicians in this Arm received two prices (the inside and outside price) in the electronic medical record at the time of ordering in addition to the paper memo.

Interventions

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Single median price information

Physicians in this Arm received a single median price in the electronic medical record at the time of ordering in addition to the paper memo.

Intervention Type BEHAVIORAL

Paired inside/outside price information

Physicians in this Arm received two prices (the inside and outside price) in the electronic medical record at the time of ordering in addition to the paper memo.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

• Providers who can place orders in the EMR independently and who have worked at ATRIUS since 2013.

Exclusion Criteria

• Providers who do not use the common electronic medical record system, cannot place orders in the electronic medical record independently (e.g., registered nurses, licensed practical nurses, registered dieticians), worked after hours Telecom, or were per diem.
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Robert Wood Johnson Foundation

OTHER

Sponsor Role collaborator

Atrius Health

OTHER

Sponsor Role collaborator

Boston Children's Hospital

OTHER

Sponsor Role lead

Responsible Party

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Alyna Chien

Assistant Professor of Pediatrics

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Alyna T Chien, MD, MS

Role: PRINCIPAL_INVESTIGATOR

Assistant Professor of Pediatrics, Department of General Pediatrics, Division of Medicine, Boston Children's Hospital

Locations

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Boston Children's Hospital

Boston, Massachusetts, United States

Site Status

Countries

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United States

Other Identifiers

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P00011096

Identifier Type: -

Identifier Source: org_study_id

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