Cost Conscious Care Education for Resident Physicians

From the 2018 HVPAA National Conference

Kasey Little (University of Virginia), Andrew Parsons (University of Virginia)


Health systems, payers, and patients are increasingly recognizing the need to reduce healthcare costs. Research shows that to have an effect on provider habits, they must be supplied with cost data as well as targeted education related to high value care.


We developed a cost conscious care lecture series that asks residents to adequately diagnose and treat patients while ordering as few tests as possible.


We surveyed residents on their knowledge of cost conscious care. Our educational intervention is a lecture series which encourages residents to perform thorough histories and physical exams and to only rely on additional testing when absolutely necessary. Each lecture ends with education on a diagnosis as well as the utility of tests that may have been ordered during patient evaluation. We will re-survey the residents at the conclusion of the lecture series.


Pre-intervention data shows that residents feel that cost conscious care is part of their professional obligation, and that knowing the cost of the care they provide is essential. However, nearly every resident felt that they had inadequate access to cost data. The lecture series will finish in May 2018. In June 2018, we will re-survey the residents on their knowledge of cost conscious care.


Provider attitudes and behaviors around cost conscious care are developed from the very beginning of training, yet there is little infrastructure in place to educate trainees on these topics. We believe our intervention will fill this void and are excited to see our final data in summer 2018.

Implications for the Patient

We know that cost conscious care (which includes appropriate workup but excludes unnecessary testing, medication, and hospitalization) is essential to achieving outcomes that matter to patients.

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