June 17, 2016 — As the consumerism movement grows, patients are empowered not only to educate themselves about basic health concerns, but also the costs associated with care. Between the rising cost of healthcare itself and the larger portion of those costs that individuals are shouldering, more Americans are taking the initiative to find options for better-value care.
Until recently, it has been difficult for consumers to find out in advance what their costs will be, according to a report from the General Accounting Office. The report also acknowledges that price transparency isn’t easy. Neither doctors nor patients necessarily know before a visit what combination of tests or treatments will be needed; so how would a patient know what pricing questions to ask prior? Also, providing price information across patients’ many different insurance plans and rate structures is challenging.
Nevertheless, providers are making strides to provide cost transparency with estimation tools, online calculators and dedicated pre-service staff. Healthcare organizations that emphasize quality and are transparent about pricing make it easier for patients to trust them, thereby increasing loyalty.
For their part, consumers are taking baby steps when it comes to price transparency. In a 2015 survey of 2,000 Americans, the non-profit organization Public Agenda found that 56 percent of Americans have tried to determine out-of-pocket expenses before getting care but only 21 percent have compared prices across different healthcare providers. In fact, 57 percent of insured Americans don’t realize that physicians could charge different prices for the same service. But the overall research suggests that consumers have a strong desire for this information.
Which leads to the next step in the process … helping consumers understand and use the data appropriately. In a Health Affairs article, University of California health economics professor Kathryn Phillips accurately observes, “You can’t just put price information out there and expect people to use it.”
Some basic questions: How are consumers interpreting and using the information they’re getting? Do they equate the quality of healthcare with its corresponding cost? Will patients avoid low-price care if they associate price with quality?
Most people don’t associate the price of care with the quality of care, according to Phillips and co-authors David Schleifer and Carolin Hagelskamp of Public Agenda. In the Health Affairs article the trio states, “It may be that people who already think better care costs more money are more likely to be comparing prices. But if comparing prices somehow causes people to think that better care costs more, then the governments, insurers and other companies who are developing transparency tools need to figure out how to address those perceptions.”
The Public Agenda report offered basic suggestions to engage consumers in the price transparency discussion:.
• Help them understand how to find price information
• Help them understand that prices vary
• Extend your patient engagement efforts to people caring for others and those who receive regular medical care
Who Is Looking for Price Information?
• 56 percent of Americans say they have tried to find out how much they would have to pay out of pocket—not including a co-pay—or how much their insurer would have to pay a doctor or hospital, before getting care.
• People with higher deductibles are more likely to have sought price information: 67 percent of those with deductibles of $500 to $3,000 and 74 percent of those with deductibles higher than $3,000 have tried to find price information before getting care.
• People with college degrees and women are more likely to have sought price information than those without degrees and men—62 percent of those with college degrees and 59 percent of women report having done so. Only 40 percent of retired Americans report having done so.
• There are no significant differences by income, age or race/ethnicity in whether or not people have sought price information when taking into consideration other relevant variables.