Physician awareness of cost under prospective reimbursement systems.

The failure of some strategies to reduce physician use of costly hospital services has been attributed in part to retrospective reimbursement systems. However, anticipation of changes in the reimbursement structure has led to speculation that a different environment might lead to increased cost awareness by physicians. To measure the impact of prospective reimbursement systems on physician awareness of cost, the authors surveyed 46 medicine residents and faculty at a medical center. Data show that only 34% were able to correctly estimate common charges and 24% less common charges. In the early stages of prospective reimbursement, there has been no increased physician awareness of cost.