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Clear On the Cost - MCN's New Project

clinician with patient

How many underserved or mobile patients give up on their treatment plan, because they find they can’t afford it? How well informed were those patients of the long term costs, before treatment began? Did the patients feel that their financial concerns were heard by their clinicians? This week, to answer some of these questions, Migrant Clinicians Network launched a new project to address a topic that is too often the elephant in the exam room: the out-of-pocket costs for the patient.

The one-year project, Clear on the Cost: Patients and Providers Co-Authoring Care Plans, aims to evaluate and strengthen conversations about the cost of care (COC) between clinicians and underserved patients at Federally Qualified Health Centers (FQHCs).

“Reducing uncertainty about the costs of care among vulnerable patients and families is the goal. We anticipate that frank and informed discussions from both clinical and administrative professionals will increase trust and compliance with new or modified care plans in these patients, and may indirectly improve outcomes,” explained Douglas D. Bradham, DrPH, MA, MPH, Project Director. “This is a great opportunity to contribute evidence-based, practical ideas to the clinical process in FQHCs and, by diffusion, in other primary care practices.”

The project, funded by the Robert Wood Johnson Foundation, will help patients have a better understanding of their care plan and expected costs -- but that’s just one anticipated outcome of the enhanced clinician-patient COC conversations. A structured, empathetic message coming from a clinician may foster trust and potentially change the dynamic between the clinician and patient to one where the patient feels that her financial concerns and external obligations are being considered. The strengthened relationship may translate into better understanding of the recommended treatments and greater treatment adherence.

“We hope the strengthened relationship will translate into the patient’s improved understanding of the recommended treatments and greater treatment adherence,” said Jessica Harrington, MCN’s Grant Writer and the coordinator of this project. Harrington, along with Deliana Garcia, MA, Director of International Projects, Research, and Development and Co-Project Director, will launch the first phase of the project this month.

The project will begin with evaluations to determine exactly how far COC conversations are currently occurring, and how patients interpret those conversations once they’ve left the health center, at FQHCs in four states. During the course of the project, Dr. Bradham says, MCN will “measure the impact of approaches to optimize cost of care conversations in realistic and practical ways for migrating populations, whose health care financing capacities may change significantly due to external factors,” like family support needs and seasonal work fluctuations.

After testing out our onsite training materials, we will launch the materials and gather research to see their effect. The project builds on five years of research led by Garcia that MCN previously conducted through our HepTalk program on emotionally charged conversations between clinician and patient.

Learn more about all the projects funded by Robert Wood Johnson Foundation at their website. Read more about MCN’s newly funded project here.

For more information on this project, contact Jessica Harrington at or 512-579-4534.


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