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May 2014
Prices coming to Epic

Sometime soon, Epic will provide information on Medicare reimbursement rates for laboratory/blood bank orders. These will be rates for outpatient testing across Yale New Haven Health System. It is important that clinicians recognize these are neither “costs” nor “charges,” but simply what Medicare reimburses hospitals for the testing. We considered actually listing our costs, but these vary across YNHHS whereas the Medicare reimbursement rates do not.

Similarly, actual charges could be placed in the system, but these also vary by hospital. These rates will be visible in the inpatient order entry modules. Clinicians have also persistently asked for this transparency. They are recognizing the intense pressure on organized medicine to control cost, and it is very difficult to control costs without knowledge of relative expenses. While reimbursement rates do not equate with “cost,” they are, of course, related and we believe these data will provide considerable insight into how we use these resources. The intent of providing this information, of course, is not to limit what is important to do in the care of patients. That recognized, there is extraordinary individual variation in how physicians approach testing and some of this undoubtedly relates to lack of knowledge of both the utility and expense of what we order.

Overall, prices will be displayed in a simple, clear and unobtrusive way that will not add steps to the ordering process. We will be assessing our progress with this work over the summer and evaluating whether additional services will benefit from display of publicly available Medicare reimbursement rates. More information about the price display will be available through the Epic log-in screens. We hope clinicians find this information useful. We will welcome your feedback.

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