Table 2.

Primary Care Physician (PCP) Views on and Experience with Price Information

Themes identified	Representative quote(s)
1. PCP “gut reactions” to price information ranged from positive to negative.	“I’m all for [price transparency]… I think we have no clue as physicians what things cost.” -Female PCP in practice for 37 years, sees patients 4.8 days per week plus has administrative duties “I don’t know what [price transparency] is supposed to do other than make you feel bad.” -Female PCP in practice for 20 years and sees patients 5 days per week
2. PCPs with all ranges of “gut reactions” were interested in having patient-specific price information.	“I think it would be very beneficial if I know that if [the price] is specifically for this patient for this kind of insurance and what will be the out-of-pocket [spending] for this particular patient.” -Male PCP in practice for 25 years and sees patients 4 days per week “More patient-specific data would actually probably have a pretty significant impact on what we wind up doing.” -Male PCP in practice for 19 years, sees patients 3.5 days per week plus has administrative duties
3. Having price information only slightly altered test-ordering heuristics.	“An ultrasound is cheaper than a CT scan, so if I would get enough information by that, I would then order the ultrasound.” -Female PCP in practice for 31 years, sees patients 2.5 days per week “For some of the X-ray stuff, I kind of try to keep in the back of my mind like, ‘This is pretty costly. Is it going to change anything?’” -Female PCP in practice for 23 years, sees patients 4.4 days per week
4. When patients’ affordability concerns were revealed, price information helped PCPs engage patients in conversations about how to alter treatment plans.	“[Patients will] say, ‘You know, but I haven’t met my deductible. This test is going to cost so much, or how much do you think it will cost? Can we wait on this?’ And then we discuss pros and cons.” -Female PCP in practice for 31 years and sees patients 2.5 days per week “We’ll look at the [information] together and [I’ll] say, ‘I’m worried you have a pituitary adenoma. The MRI is going to cost you $3,000, but we can get a non-contrast head CT scan for $500 and it will probably give you the same information.’” -Male PCP in practice for 23 years and sees patients 4 days per week
5. PCPs avoided mentioning price information when advising patients against unnecessary testing.	“Some people, when you tell them the cost of something…they feel like you are trying to limit care for them because of the cost. So I do try to be careful about using [price information].” -Female PCP in practice for 18 years and sees patients 4 days per week “I really try not to [use price information when advising patients against unnecessary testing] because most patients will rear back in disgust if you bring it up as a clinician. I do frequently bring up evidence-based medicine as an explanation for why I am or am not doing something.” -Male PCP in practice for 17 years, sees patients 3 days per week plus has administrative duties
6. PCPs felt that physicians bore chief responsibility for discussing prices with patients because of their clinical knowledge and relationships with patients.	“All of those [clinical] subtleties, I don’t think anyone else [other than physicians] would really be able to discuss with the patient.” -Female PCP in practice for 13 years and sees patients 3.8 days per week “You’ve got to have the clinical information in there. The patient needs to know what does that mean and they need to be reassured that if they don’t do something, they’re not doing something bad for themselves.” -Female PCP in practice for 23 years, sees patients 4.8 days per week plus has administrative duties
7. PCPs wished for help from patients, practices, health plans, and society in order to support price transparency in healthcare.	Patients. “[Patients] should know what their insurance covers…they’re the ones who selected their insurance with the copays, deductibles, other out-of-pocket expenses.” -Male in practice for 13 years and sees patients 3.8 days per week “[Patients say], ‘I don’t care about how much this [test] costs because my insurance company pays for it.’ And [I] say, ‘Yes. You do care…because your premium would go up.’” -Female in practice for 18 years and sees patients 4 days per week Practices. “It would be great if there was a little office of how to help you with the cost of your medical care right here [in the office].” -Female PCP in practice for 37 years, sees patients 4.8 days per week plus has administrative duties “Maybe when we send out [patient] letters saying, ‘You need your routine physical, and we believe that you need the following: a mammogram, a colonoscopy, a lipid panel; and this is what it’s going to cost you.’” -Female PCP in practice for 14 years and sees patients 5 days per week Health Plans. “The insurance companies don’t get involved enough in being transparent about what their insurance covers, what their rules are. Nowadays I feel like they turf it to us.” -Male PCP in practice for 3 years and sees patients 5 days per week Society. “I could envision a more transparent society where on the website you could be curious about the cost of your care. People could just click on ‘How much does an MRI cost’ and how much does this cost and how much does that cost.” -Male PCP in practice for 19 years, sees patients 1.5 days per week plus has administrative duties