ON THE AGENDA | AUGUST 4TH, 2016 | Allison Rizzolo
Anecdotes and research both suggest most health care price transparency efforts are so far falling short.
Arriving at her dermatologist’s office last week, my friend Emily discovered her health insurance network had changed. The doctor she'd visited for many years was no longer in network.
Naturally concerned about how much the appointment would cost her, she asked the receptionist. The receptionist didn’t know but offered to call Emily’s insurance company. The insurance company told her that part of her appointment would not be covered by her deductible, but they couldn’t tell her how much that would cost. All Emily knew was that an appointment that should have cost a co-pay of $20 would likely cost her $400, perhaps more. Emily said thanks and left.
Health care leaders, advocates, researchers and policymakers are trying to limit these sorts of frustrating experiences by improving price transparency in health care. States including Oregon and Florida have passed legislation calling for increased transparency in the prices of health care providers. Insurers are developing tools and websites with price and quality information for customers. For-profit and nonprofit companies and organizations are doing the same.
Anecdotes and research both suggest most of these efforts are so far falling short. Journalists have written about the frustration they and others encounter when trying to find the prices of pregnancy, joint replacement, MRIs and other common procedures.
For the last four years, two organizations – Health Care Incentives Improvement Institute and Catalyst for Payment Reform – have tracked state's efforts to boost price transparency with an annual report card. In the most recent edition, released last week, 43 states received an F grade. Just three received an A.
Meanwhile, most Americans seem to be seeking more and better price information for health care. In a recent survey we conducted, over half of Americans – 56 percent – said they had tried to find out how much their health care would cost them out of pocket. One in five (21 percent) compared prices across two or more providers. Those who have compared prices say doing so has affected their choices and saved them money.
As health care leaders and experts continue to improve patients' access to price information, they need to make sure they are meeting the needs and concerns of patients and caregivers. Otherwise, their efforts may just continue to fall flat.
For example, some health care experts have emphasized the need to make websites and online tools user-friendly and simple to navigate. Our work with prospective students in the higher education sector suggests a need to make big data meaningful and applicable to the user's own life and experiences.
Our price transparency research provides additional direction and suggestions:
This year, we are repeating our survey on price transparency to identify trends and new concerns. We are also doing additional research into public attitudes toward health care quality. Both of these studies will be released in the coming year. Stay on top of our health care research by signing up for our email list!