How HSAs are affecting clinical decision making

Look for this trend to increase as cost becomes a bigger factor in whether a patient accepts a treatment plan:

The patient won temporary relief from a steroid injection after her ongoing shoulder pain didn’t respond to anti-inflammatories. But when the pain returned, her internist recommended physical therapy.

“And then she said, ‘I have a high-deductible health plan. How much will that really run me?’ ” said Robert M. McLean, FACP, a rheumatologist at Connecticut Medical Group, a 15-physician practice in New Haven, Conn. The patient balked at the total – —and declined the therapy. “Suddenly $50 or $60 three times a week for a month starts to add up.”

Instead, he offered her another steroid injection, marking the first time in his 12 years of practice that he’d truly altered a treatment recommendation – not just a medication option – —to accommodate a patient’s response to a cost-benefit analysis.

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