David Schleifer and Andrea Ducas
Originally published at Health Affairs Blog on March 26th, 2015.
Most insured Americans pay health care deductibles and coinsurance, with cost-sharing rates that seem to be continually increasing. At the same time, millions of uninsured people face unpredictable and often high charges for medical care.
In other words, Americans have a significant amount of “skin in the game” when it comes to health care. That said, it’s not easy for most people to find out how much their health care will cost—let alone to find lower-priced care. The opacity of health care prices is one major reason for this. Despite the fact that so many Americans must pay for so much of their medical care out of pocket, easy access to accurate price information remains far from routine.
This month, Public Agenda, with support from the Robert Wood Johnson Foundation, released the results of a national survey finding that 56 percent of American adults say they have tried to find out their out-of-pocket costs (excluding a copay) before getting the care they needed, or have tried to find out how much their insurance would pay a doctor or hospital. In other words, despite the opacity of price information, the majority of Americans have at least tried to find out how much their care would cost.
The survey also found that the majority of Americans do not believe that higher prices are typically a sign of better quality. Together, these findings suggest that Americans are open to looking for better-value care.
But just because people are looking for price information does not necessarily mean they are comparing prices. Looking more closely at the 56 percent of Americans who have tried to find out how much their care would cost, 33 percent of all Americans checked prices from just one provider, and only 21 percent of all Americans compared prices across multiple providers (for the remaining 2 percent, our survey could not determine whether they had checked or compared). However, the majority (62 percent) of those who did compare prices say they saved money by doing so.
So why aren’t more people shopping around? Our survey suggests one possible reason: a substantial number of insured (57 percent) and uninsured (47 percent) Americans are not aware that physicians might actually charge different prices to different people for the same services. Our follow-up interviews also indicate that people may not compare prices because they are unable or unwilling to change providers.
In our report, we highlight a number of recommendations for insurers, employers, policy makers, and providers who want to make price information more easily available to patients and families, including the following:
While seeking out and comparing prices may not be appropriate for everyone or for every medical situation, many Americans are open to using price information to choose better-value care.
We invite you to dig into our full report and its implications here.