First, Do No (Financial) Harm: Having Value Conversations with Patients About Tests

More Americans than ever before are now on high-deductible insurance plans, meaning they have to pay out-of-pocket for at least the first few thousands of dollars of healthcare costs before their insurance coverage kicks in. For the average American, these out-of-pocket costs can be financially burdensome and have led to an increasing recognition that medical care can result in a side effect called “financial harm”. This financial harm can lead to other negative downstream effects, such as patients avoiding future helpful medical tests, procedures, or therapies; an inability to participate in other health programs; or going without basic needs such as food. Because of higher out-of-pocket costs, patients want to know how much their health care may cost them ahead of time and ways that they can mitigate these costs. Using a simple, 3-step framework, clinicians can work together with their patients to help address costs of care and reduce financial harm.

Activity Length
Pretest: 5 minutes | Video 1: 11 minutes | Posttest 1: 3 minutes

Target Audience

This activity has been designed for health care providers of all specialties including physicians, nurses, nurse practitioners and physician assistants.

Learning Objectives

At the conclusion of this activity, participants will be able to:

  • Discuss the problem of “financial harm” for individual patients;
  • List the three steps of the “First, Do No Financial Harm” framework;
  • Demonstrate strategies for discussing costs and the value of recommended medical procedures with price-sensitive patients.
Additional information
ACGME/ABMS Core Competencies: 
Patient Care and Procedural Skills
Practice-based Learning and Improvement
Interpersonal and Communication Skills
Systems-based Practice
For more information, please contact:
CME Coordinator Contact Name: 
September Wallingford
CME Coordinator Contact Email: 
Available credit: 
  • 0.25 AMA PRA Category 1 Credit™
  • 0.25 Participation
Activity opens: 
Activity expires: 
Physician Credit
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of The University of Chicago Pritzker School of Medicine and Costs of Care. The University of Chicago Pritzker School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.
The University of Chicago Pritzker School of Medicine designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Other Healthcare Professions Credit
Nurses and other healthcare professionals will receive a Certificate of Participation. For information on the applicability and acceptance of certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the ACCME, please consult your professional licensing board.
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