Description and Evaluation of an Educational Intervention on Health Care Costs and Value

Abstract

A B S T R A C T OBJECTIVE:There is growing consensus that to ensure that health care dollars are spent efficiently, physicians need more training in how to provide high-value, cost-conscious care. Thus, in fiscal year 2014, The Children's Hospital of Philadelphia piloted a 9-part curriculum on health care costs and value for faculty in the Division of General Pediatrics. This study uses baseline and postintervention surveys to gauge knowledge, perceptions, and views on these issues and to assess the efficacy of the pilot curriculum. METHODS:Faculty completed surveys about their knowledge and perceptions about health care costs and value and their views on the role physicians should play in containing costs and promoting value. Baseline and postintervention responses were compared and analyzed on the basis of how many of the sessions respondents attended.RESULTS: Sixty-two faculty members completed the baseline survey (71% response rate), and 45 faculty members completed the postintervention survey (63% response rate). Reported knowledge of health care costs and value increased significantly in the postintervention survey (P 5 .04 and P , .001). Odds of being knowledgeable about costs and value were 2.42 (confidence interval: 1.05-5.58) and 6.22 times greater (confidence interval: 2.29-16.90), respectively, postintervention. Reported knowledge of health care costs and value increased with number of sessions attended (P 5 .01 and P , .001). CONCLUSIONS:The pilot curriculum appeared to successfully introduce physicians to concepts around health care costs and value and initiated important discussions about the role physicians can play in containing costs and promoting value. Additional education, increased cost transparency, and more decision support tools are needed to help physicians translate knowledge into practice.

Teaching High-Value Care in Pediatrics: A National Survey of Current Practices and Guide for Future Curriculum Development

“…Finally, our survey supports the fact that targeting faculty-and attending-level providers for HVC education efforts may be important in addition to cost transparency, as both were identified as key barriers to performing HVC. There has already been a successful effort in pediatrics to train attending-level providers on cost, 26 and spreading this effort to other areas may yield positive results. Institutions that only target trainees for HVC education risk creating conflict between this formal curriculum and the informal or ''hidden'' curricula we often see in clinical care.…”

Development and Evaluation of High-Value Pediatrics: A High-Value Care Pediatric Resident Curriculum

“…Lectures were adapted from a previously described faculty development curriculum. 30 Topics include an introduction to value in health care, health care costs, balancing cost with other important factors in health care, and high-value diagnosis. Key objectives are used to address comprehension, knowledge, and application.…”

“…Quantitative data collection occurred via an anonymous, voluntary REDCap (Research Electronic Data Capture) 32 survey adapted from a previously published tool (see Supplemental Fig 3 for the complete tool), 10,30 and the survey was distributed to all residents before initiation of the curriculum in July 2016 and after exposure to the curriculum in May 2017 (6 months after completion of lecture series).…”

Pediatric Training Faculty and Resident Perceptions on Teaching High-Value, Cost-Conscious Care: A Multi-Institutional Study

“…The Children' s Hospital of Philadelphia recently piloted a multipart curriculum for general pediatricians and found that it improved HVCCC knowledge and perceptions, although change in actual practice was not assessed. 17 Although the literature is not entirely conclusive, a 2015 systematic review showed that presenting charge data to physicians generally changed ordering practices without impacting the quality of care. 18 Because transparency about pricing data is highly variable, publicly available websites such as the California Chargemaster and Healthcare Bluebook may provide useful surrogate materials for programs.…”