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Resource Details


Complicated Conversations on Cost
MCN Research Article

Resource Topic: Social Determinants of Health (SDOH), Clinical Issues, Special and Vulnerable Populations

Resource Subtopic: Health Equity.

Year Developed: 2019

Resource Type: Publication

Primary Audience: n.a.
Secondary Audience: Administrative Staff Board of Directors C-Suite (CEOs, CFOs, CIOs, COOs, CMOs, etc) Clinicians

Language: English

Developed by: Migrant Clinicians Network (See other resources developed by this organization).

Resource Summary: This new MCN publication joins a growing body of research pieces and articles detailing the complexity around having a cost of care conversation. Last week, the New York Times published a piece entitled, “They Want It to Be Secret: How a Common Blood Test Can Cost $11 or Almost $1,000.” Using the routine metabolic blood panel as the example some insurance companies provide consumers with tools to help shed light on cost, but in many cases you won’t know the price your insurance company agreed to until you get the bill.

Resource Details: How many clinicians hold a conversation with patients around the potential costs of this visit’s care? For low-income patients, who have little to no savings, the fear of paying for a health crisis increases the anxiety and stress around the diagnosis itself, including a chronic condition like diabetes. And yet, according to a paper published this week in the Annals of Internal Medicine, discussion around cost of care occurred during less than half of observed patient encounters, and only 11.9 percent of physician-patient encounters included a discussion of the cost of treatment plans. The Robert Wood Johnson Foundation-funded research was conducted by Douglas D. Bradham, DrPH, MA, MPH, a health economist and policy expert, and Principal Investigator of Migrant Clinicians Network’s “Clear on the Cost” study; Deliana Garcia, MA, MCN’s Director of International Projects and Emerging Issues; Alma Galván, MCN’s Senior Program Manager; and Corey Erb, MCN’s former Research Assistant and Executive Associate.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $6,375,000 with 0 percentage financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit