Sending emails to reduce medical costs? The effect of feedback on general practitioners’ claiming of fees

Audit and feedback is employed as a strategy to guide practices of health care professionals towards certain targets. The outcome of interest can be quality improvements, but also ensuring that health care workers adhere to relevant regulations. We conducted a nationwide field experiment in the Norwegian primary care sector to study the behavioral responses from giving general practitioners feedback (GPs) on their claiming of fees. The email-based feedback intervention targeted GPs who most frequently claimed fees for double consultations and provided them with a reminder of the formal regulations for double consultations. The intervention caused a 3–4 percentage point reduction in the use of the double-consultation fee, reducing the yearly health care spending of the Norwegian government by approximately to €480 000 per year. This substantial and durable behavioral response found in our study sample comprising 15 % of Norwegian GPs, shows that low-cost interventions via email can have significant financial impact.