by John W. Mitchell
, Senior Correspondent | April 07, 2016
For the first time, researchers have some insight into who uses pricing tools to gather cost information on a range of medical procedures. But according to a study of one price calculator tool just published in Health Affairs, price transparency still has a long way to go.
They looked at data from adults aged 19-64 who had health insurance with Aetna to evaluate how patients used the insurer's "Member Payment Estimator".
“In the first two years the tool was available, which were in 2011 and 2012, we found about 320,000 people – 3.5 percent of all with access — used the price shopping tool,” Anna Sinaiko, Ph.D., research scientist at the Harvard T.H. Chan School of Public Health and co-author of the study told HCB News.
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“Shoppers were more likely to be younger than age 35, have higher deductible spending, and to be healthier than other patients, on average," she added, and more woman did so than men.
The most common procedures researched using the calculator were preventive screening services (colonoscopy, mammogram), childbirth, imaging procedures, and some non-emergent and elective outpatient services.
According to Sinaiko such tools are designed to give people “meaningful price information”, which is an important factor in understanding individual out-of-pocket costs and creating price transparency.
“If we want patients to be engaged in decision-making about their health and health care, then good information, like that provided on price tools like the Aetna one we studied, are an important first step,” she said. “Educating and engaging consumers with this information should be next.”
According to the nonprofit Catalyst for Payment Reform (CPR), almost all states do a poor job of creating health cost transparency. In its 2015 annual survey for health care price transparency, 45 states got an “F” for their efforts to inform and educate their citizens about health care costs.
CPR maintains that price transparency is a contentious issue among health care providers. Providers claim such information is irrelevant, because most people pay a discounted price negotiated with their health insurance carrier. However CPR concedes that more consumers are starting to shop around for health care, a point that Sinaiko also stresses.
“Sophisticated health care price shopping tools are increasingly available to individuals with health insurance,” said Sinaiko. “We know that patients care about health care costs and are interested in having more price information.”