ON THE AGENDA | APRIL 12TH, 2016 | ALLISON RIZZOLO

Americans Don't Associate Price with Quality in Health Care

Findings underscore the need to publicly report information about price AND quality.

Does your insurance company provide a website or other resource for you to look up health care prices? If so, they're part of a growing trend. More and more government agencies, insurance companies and nonprofit organizations have developed tools to help patients navigate the complicated and often opaque health care price system.

As these resources proliferate, some health care experts worry that, if patients assume price is associated with quality, they'll avoid low-price care. After all, it's only reasonable to believe that price and quality are related. Yet while health care prices vary widely throughout the country, there is no evidence that higher prices are associated with higher quality or better health outcomes.

A new analysis of our 2015 survey data on price transparency provides good news for those troubled experts: most Americans do not associate the price of health care with the quality of that care. The analysis, conducted by Public Agenda's David Schleifer and Carolin Hagelskamp together with Kathryn Phillips of the University of California, San Francisco, was published in the April issue of Health Affairs, a top health policy journal.

In the analysis, we found that a majority of Americans (ranging from 58-71 percent depending on how the questions were framed) do not think health care cost and quality are associated. Fewer than one-quarter (21-24 percent) perceive an association, while 8-16 percent are unsure.

The findings have implications for the movements toward transparency and price shopping. Specifically:

Providing price information will not necessarily prompt consumers to choose higher-price providers instead of lower-price ones.

While most Americans don't associate price with quality, many are unsure. This underscores the need to publicly report information about price AND quality.

Individuals who say they've compared prices are more likely to perceive that price and quality are associated. We don't know whether there is a causal relationship between comparing health care prices and associating price and quality. However, it's important to better understand this finding and ensure efforts to boost price transparency don't have unintended consequences.

People were less likely to believe price and quality were associated if they were asked about high price/high quality care, rather than low price/ low quality care. Framing of information matters, which suggests that price and quality transparency initiatives need to consider how price and quality information are communicated.

The April Health Affairs issue focused on patient engagement, and there were a number of other articles we think you'll be interested in. These include pieces about:

If you're interested in patient engagement on health care costs, quality and prices, register for our email list and we'll update you on our work in these fields. Also check back on our blog every Friday, when we post engaging articles, reports and studies we've come across on topics including health care, education, democracy, public engagement and public opinion research here's last week's.


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