- When it comes to price transparency tools and shopping around for healthcare services, patients are not entirely sold, according to qualitative research published in the American Journal of Managed Care.
As patients face higher out-of-pocket costs and deductibles, payers and other stakeholders are encouraging patients to use price transparency tools to shop around for their care. There are over 60 online resources for price transparency and comparing, the research team said, making this practice feasible.
Additionally, price transparency supports the notion that patients should make their own decisions about where to access their care based on quality metrics and cost information.
Specifically, employer-sponsored health plans and other private payers are encouraging patients to look at facilities that offer price transparency and make the best financial responsibility.
“Numerous employers have introduced price transparency tools to their employees, which aim to engage individuals with easily accessible price data so they can shop for low-cost providers,” the researchers said.
However, there is scant information about how patients feel about price transparency and healthcare shopping, as well as evidence about how many patients are engaging with healthcare in this manner.
Through a series of qualitative interviews with patients enrolled in preferred provider organizations, the researchers determined that patients haven’t completely embraced healthcare shopping, although they are keeping an open mind to it.
The team conducted interviews with 200 California Public Employees’ Retirement System (CalPERS) beneficiaries, yielding a 39-patient response rate. Of those respondents, 17 reported frequent price transparency tool use (four or more log-ins), 13 used it infrequently (between one and three log-ins), and nine had never used the tool.
High healthcare costs and price inconsistency between providers frustrated the patient respondents.
“Many felt like they did not have control over their or their family’s healthcare spending beyond taking the initial step to seek medical care,” the investigators found.
While patients generally approved of the idea of a price transparency tool, they expressed two primary barriers.
First, the tool’s salience was lacking. Patients often forgot to use the tool in time to make a healthcare decision, or found its use fruitless.
“Several respondents noted that it was unimportant to shop for care because they were already beyond their deductible or because their co-payment for an office visit was always the same,” the researchers said.
Other care barriers kept patients from seeing the point of a price transparency tool.
“Many—in particular, those in rural areas—felt it was not useful to shop for care because there was a limited set of providers they could see within their health plan’s provider network,” the research team added. “Others were skeptical of the usefulness of the price information on the website because it did not account for the tests or referrals the physician might order during a visit.”
Second, patients said that many other factors drive their healthcare decisions other than cost. Care quality and loyalty mean more to patients than seeing a cost reduction.
“Overwhelmingly, respondents did not want to shop for care because of loyalty to their current providers,” the researchers found. “Many respondents commented that differences in price were relatively unimportant when it came to their primary care physicians (PCPs) and specialists with whom they had an established relationship.”
Some patients said that price transparency tools could be useful in driving market competition and reducing costs (much like shopping at different care dealerships, for example). However, several respondents expressed that money does not matter in health affairs.
That is not to say that patients do not see any use for price transparency tools. Patients often use them for non-emergency care, imaging, and labs. Patients also use price transparency tools to track their claims and deductible statuses.
If payers and employers continue to encourage price transparency for these purposes, they may boost tool use in other areas, as well.
Ultimately, patients need better guidance from the healthcare industry while using price transparency tools. While some patients need more reminders to use the tools during healthcare decisions, others may benefit from knowing when they should use the tool and for what services.
“For price transparency tools to be used more effectively, the public needs education and reminders about how, when, and why they should price shop,” the researchers concluded. “[Patients] need reminders about the availability of price data and ideally to be provided with the data at the time of decision making, especially for services that could be defined as shop-able.”