Are Primary Care Physicians Ready to Practice in a Consumer-Driven Environment?

Objective:To evaluate physicians' readiness to care for patients enrolled in consumer-directed health plans (CDHPs), which change the nature of cost sharing and medical decision making in primary care. Study Design: Mailed cross-sectional survey of 1500 nationally representative primary care physicians. Methods: Physicians' knowledge of CDHP benefit design, readiness to advise patients about financial issues, and views regarding the role of quality-of-care information in patient decision making were assessed. Results were analyzed using descriptive statistics and multivariate models. Results: Five hundred twenty-eight of 1076 eligible physicians (49%) responded to the survey. Forty percent of physicians had CDHP enrollees in their practices. Forty-three percent of physicians reported low knowledge of CDHP cost sharing, and approximately one-third reported low knowledge of how medical savings accounts function. Overall, physicians with CDHP enrollees in their practices had higher knowledge than physicians without these patients; however, 1 in 4 of these providers reported low knowledge of CDHP cost sharing. More than two-thirds of all physicians were ready to advise patients on the costs of office visits, medications, and laboratory tests; approximately half or less were ready to advise on the costs of radiologic studies, specialist visits, and hospitalizations, Forty-eight percent were ready to discuss medical budgets with patients. Twenty-one percent of physicians thought that patients could trust quality-of-care information from government Web sites, and 8% thought that patients could trust quality-of-care information from insurance Web sites. Conclusion: Many primary care physicians report low knowledge of CDHPs, limited readiness to advise patients on issues of cost and medical budgeting, and minimal trust in quality-of-care information. (Am J Manag Care. 2008;14(10):667-668)