Connecting Consumers to Health Care Price and Quality Tools

NYHealth awarded grants to NYSAFP, NYACP, and Avalere Health to support the launch of the Connecting Consumers to Information initiative.

Grantee Name

I.M. Research and Service Corporation for the New York Chapter, American College of Physicians (NYACP); New York State Academy of Family Physicians (NYSAFP); and Avalere Health

Funding Area

Empowering Health Care Consumers

Publication Date

June 2021

Grant Amount

$249,626 to NYCAP; $200,971 to NYSAFP; $25,000 (2018) and $89,907 (2019) to Avalere Health

Grant Date:

February 2018-April 2020

Empowering Health Care Consumers

Patients are increasingly responsible for out-of-pocket spending for care, and they have a right know, upfront, how much their care will cost.

A survey co-funded by NYHealth found that a majority of Americans are searching for price information in health care. Most respondents indicated that they want to know how much a medical service will cost them before receiving care, but they are unsure of where to look. Many people are also unaware that some quality information already exists to support their information needs and decision-making. Despite the availability of cost and quality websites and tools, their use is low.

As a result, consumers continue to look to their physicians as a trusted source of price and quality information. But a range of barriers make it difficult for conversations about cost and quality to happen during clinical encounters. The barriers include time constraints and short patient visits, competing priorities in those brief visits, and lack of training on how to have such conversations. Some physicians hold the attitude that discussions about money don’t belong in the exam room and that they don’t want cost considerations to be seen as compromising care. Clinicians and staff members need to be better equipped with the tools and skills to have these conversations with patients.

Recognizing the trust that patients place in their own physicians, NYHealth launched the Connecting Consumers to Information initiative to put price and quality tools into the hands of primary care physicians and staff members and encourage their use by their patients. NYHealth awarded grants to the New York Academy of Family Physicians (NYSAFP) and the New York Chapter, American College of Physicians (NYACP) to help their members hold these cost-of-care conversations with patients and connect them to resources. NYHealth also awarded complementary funds to Avalere Health in 2018 and 2019 to provide guidance and technical assistance to the member networks.

Outcomes and Lessons Learned


  • Provided training and raised awareness about cost-of-care and quality concepts and tools among their membership networks, which represent 18,000 physicians, residents, and medical students.
  • Surveyed members at the start and end of the initiative to understand changes in knowledge and receptiveness of cost-of-care conversations, as well as guide the development of resources. For example, 33% of NYSAFP respondents reported never having a cost-of-care conversation at the beginning of the initiative; by the initiative’s end, only 5% reported never having this kind of conversation.
  • Assessed and compiled online and hard-copy price and quality resources, including tools such as GoodRx, Fair Health, and Choosing Wisely.
  • Launched an early adopter mini-grant program for both physicians and nonclinical staff. Activities included:
    • Recruited 23 physician practices (10 NYSAFP members and 13 NYACP members) to participate in the mini-grant program. These practices incorporated the use of cost estimate tools into their culture and trained staff to have cost and quality conversations with patients.
    • Tracked measures including frequency of financial screening; type of conversation and tool used (i.e., quality, cost, or both); and the number of patient interactions. In total, participating physician practices initiated more than 25,000 conversations and nearly 30,000 financial screenings with their patients.
  • Held trainings and shared resources through newsletters, webinars, podcasts, and social media, including conversation guides, self-assessment questionnaires, and sample workflows.

Avalere Health:

  • Provided member networks with counsel and hosted roundtable sessions for physicians to share best practices.
  • Gathered ongoing feedback from the member networks and developed a curriculum for providers to have cost-of-care conversations with patients.
  • Monitored and assessed the needs of the member networks and created educational resources in English and Spanish.
  • Synthesized lessons learned from the member networks’ efforts into a report with recommendations for similar cost and quality initiatives in the future.

Surveys throughout the project period confirmed that physicians understood the value in having these conversations. They reported that these discussions strengthened relationships and trust with their patients and could lead to improved health outcomes. On the whole, physicians responded positively to having resources in hand to help them initiate these discussions. Practices also reported creative ways for integrating conversations at their sites before, during, and after patient visits and as part of administrative activities. Medication costs were most frequently discussed, in part because physicians were the most familiar and comfortable with that topic. Over the course of the project, other topics emerged, including preventive care, labs, and imaging. Patients and practices reported that they became more aware of medication cost tools (e.g., GoodRx, NeedyMeds, pharmacy programs) and are using them more frequently.

Many practices identified physician champions and developed new roles and responsibilities among staff members, including case workers and patient representatives. Oftentimes, questions about financial concerns also revealed other patient stressors such as food, housing, and childcare. Several practices implemented strategies using case workers or navigators to assist patients with addressing these concerns—and reported better patient adherence to medical plans as a result.

Recognizing the critical importance of educating physicians early in their careers, NYSAFP and NYSACP also developed a supplementary residency training program to increase awareness and use of cost tools and concepts among medical students and residents.

Some obstacles emerged during the project. Physicians often reported that the tools were not data-specific enough for their facility and patients to be helpful. They also noted that linguistic and cultural barriers were difficult to overcome because many tools were only available in English. There are few existing tools to guide quality conversations, as well as wide variation in defining what comprises quality. As a result, most patient conversations focused on cost. In addition, patient satisfaction surveys were outside the scope of the project. Patient input on how they felt about these conversations was anecdotal; a more formal way to assess patient feedback would have been an improvement.

The relationships between NYSAFP and NYSACP with Avalere were bumpy at first. In some cases, the associations had access to their own centralized capacity-building resources, and didn’t see the need to participate in technical assistance activities with Avalere. Ultimately, the three groups identified helpful ways to collaborate with each other. Avalere began providing monthly updates on literature and tools, and co-developed an educational resource for patients and providers to encourage conversations about cost and quality.

NYSAFP and NYACP continue to promote physician-patient conversations about cost and quality. They are actively disseminating project resources and tools to members, and many member practices that participated in the mini-grant program are continuing the work. NYSAFP reported that 90% of participating practices will continue elements of the project. Avalere Health has also built on its work with NYHealth. With funding from the Robert Wood Johnson Foundation (RWJF), it has synthesized learnings to create additional materials and guidance for clinicians. It is also partnering with RWJF to assess opportunities to normalize cost-of-care conversations by using quality measures and emphasizing the notion of value.

Co-Funding and Additional Funds Leveraged: N/A