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Transparency struggles continue as few shop around for best prices, take advantage of transparency tools, studies show

Very few Americans shop around for lowest prices on healthcare services or took advantage of transparency tool when offered.

Beth Jones Sanborn, Managing Editor

Two new studies published in Health Affairs show that while Americans support the idea of shopping around for the best prices on healthcare services, they aren't doing much of it.

In the first study, authors surveyed a national sample of 2,996 nonelderly adults who had received medical care in the past 12 months with the goal of finding out how frequently patients are shopping around for prices and the challenges they may face.

Results showed only 13 percent of those who had out-of-pocket costs at their last episode of care had sought information on the potential costs beforehand, and a mere three percent had compared costs across different providers.

[Also: Battle over price transparency rages in Ohio, where new laws like Ohio's Healthcare Price Transparency Law are in limbo]

However, the lack of shopping seemingly was not fueled by a rejection of the idea. Nor did there seem to be any widespread belief that higher costs meant better quality. Rather, the issues had to do with knowing how and where to shop around, and loyalty to their current providers. Constraints imposed by health insurance provider networks also factored in here. Results showed 75 percent said they didn't know of a resource that would let them compare costs among providers. However, 53 percent said they would be likely or very likely to use a website to shop for care if one was made available to them.

"If price shopping is an important policy goal, it will be necessary to increase the availability of information on price and decrease the complexity of accessing the information. Patients often must know specific procedure or diagnosis codes to obtain prices, and differentiating between professional and facility fees makes the process even more difficult."

[Also: Price transparency for inpatient labratory tests has little effect on clinician ordering behavior, JAMA says]

A separate study showed that simply offering a price transparency tool doesn't necessarily do the trick either. Authors for this study looked at claims data for California Public Employees' Retirement System beneficiaries as well as a control population consisting of non-CalPERS Californians who were commercially insured by Anthem.

Both populations were offered a price transparency tool in the form of a website and app that let patients compare prices and out-of-pocket spending for in-network healthcare providers. It also provided some quality information. The tool focused on shoppable services including lab tests, office visits and advanced imaging. Overall, the tool was not associated with lower spending, as only 12 percent of employees offered the tool actually used it in the first 15 months it was available. Also, using the tool was not found to be related to lower lab tests or office visits.

[Also: Barriers to improving cost transparency in cancer care identified by Penn Medicine]

The average price paid for imaging services rendered after a price search was done was 14 percent lower than the price for imaging services where no price search was done. However, only 1 percent of those who received advanced imaging conducted a price search, the study said.

"For price transparency tools to have a more substantive impact on spending, a much larger percentage of patients would have to use the tools, and there would need to be a broader array of services, in addition to imaging, for which patients could effectively use price information," the authors wrote. 

Twitter: @BethJSanborn

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