Building a Cost-Conscious Care Curriculum to Improve Medical Students’ Understanding of and Participation in High-Value Healthcare

From the 2023 HVPA National Conference

Palak Patel B.S., B.A. (Wake Forest School of Medicine), Alexa Lacy B.S., Caitlin Tedeschi BS, Isabella Waung BS, Kristina Henderson-Lewis MD, MPH

One in seven U.S. households struggle with medical debt [1]. Cost conversations can strengthen the doctor-patient alliance and decrease financial toxicity, but many students and providers are uncomfortable initiating them [2].

To cultivate a more equitable and affordable health system by training medical students to present financial realities in an informational and empowering way.

All first-year medical students will participate in an Anatomy of a Medical Bill workshop [3]. Interested students can then apply for our Cost-Conscious Care Certificate, which is a high-value care curriculum that has been approved by our university. Participants will attend six high-value care workshops in their first and second years of medical school. These workshops will lay the foundation for a capstone project, which students will complete before their third year. We will evaluate the success of this program at one year of implementation using survey data.

We will judge the success of our certificate program by assessing how students grew in their knowledge of high-value care and healthcare waste using IRB-approved surveys. To assess improving literacy in cost-of-care conversations, we will ask students to participate in a simulated patient encounter and offer feedback. The capstone project will ask students to advance healthcare value in a specialty of their choice. These projects will be reviewed by our executive board both to offer guidance and to determine how students are progressing in their understanding and implementation of high-value care.

The strengths of this innovation include longitudinal teaching and assessment, involvement of faculty from diverse backgrounds and specialties, and strong institutional support. Limitations include the time-constraints of a busy medical student schedule.

Clinical Implications:
This program is a student-led, cost-effective, transferable strategy for addressing gaps in cost of care education. Ultimately, this intervention will lead to a more cost-conscious generation of physicians capable of improving patient care.

What are academic medical centers across the country doing to improve healthcare value?

Value improvement guides: Published reviews in JAMA Internal Medicine coauthored by experienced faculty from multiple leading medical centers, with safety outcomes data and an implementation blue print.

Review article detailing 25 labs to refine for high value quality improvement | July 2020

MAVEN campaign: Free 4 year high value care curriculum online.

Join the Alliance! Membership is free with institutional approval and commitment to improving value in your medical center.

Learn more about HVPA on Health Affairs Blog