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Background: The rapidly growing racially diverse, aging population in the United States is presenting unique challenges for our social, economic, and healthcare systems. Rising health care costs, increased patient cost-sharing, and limited financial resources make this generation of older Americans susceptible to large medical bills or debt which disproportionally impacts older racial/ethnic minorities. Cost-of-care (CoC) conversations between patients and doctors is one recommended approach to containing health care costs and alleviating patients’ financial burden of care.

Methods: The current study used focus group methodology to qualitatively explore the contextual factors that influence CoC conversations in a diverse sample of older adults (N=27).

Results: Three focus groups were held with White (n=10), African American (n= 9) and Hispanic/Latino (n=8) participants. Thematic analysis yielded four broad themes. Results suggest that CoC conversations are not occurring with physicians, although conversations are occurring with dentists and pharmacists. Contributors to CoC conversations included positive provider affect, rapport/relationship building, and communication. Barriers included: new age physicians, lack of physician training, wait time, lack of focus on the patient, language, provider preferences, fear of physicians, and religion; however, there was little similarity across racial/ethnic groups.

Conclusions: The results of this qualitative study suggest that cost-of-care conversations are not occurring between providers and their patients. Several barriers, contributors, and solutions to cost-of-care conversations were identified by focus group participants, which have important implications for the field, and are addressed in this manuscript.

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Research Square, v. 1, art.

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