Only 36% of consumers research pricing information for health care services, and most of those consumers turn to payers, not providers, for this information, according to a new survey from YouGov for AKASA.
For the survey, YouGov polled 2,026 adults between March 9 and March 14. In total, just 36% of respondents reported ever researching prices for health care services.
Of those who did research health care prices, 60% said they would turn to their insurance provider for pricing information. Forty-four percent of respondents who have researched prices said they would look for pricing information on health insurers' websites, while 29% said they would call their health insurance company. In addition, 39% said they would visit a physician or hospital website, 34% said they would call their physician or hospital, and 32% said they would access a patient portal for prices. (Survey respondents could select more than one option.)
When asked whether their insurer provides pricing information for local health care providers, 44% of respondents said their health insurance company does not provide that information, and 34% said they did not know if that information was available.
"As the data indicates, patients are most often either turning to their insurance company or to their care provider through a variety of platforms to understand their price of care," said Ben Beadle-Ryby, co-founder of AKASA.
As of July 1, CMS requires most health plans to publish an itemized list of the negotiated prices they pay to providers for just about all services.
Hospitals are already reporting information in line with the Hospital Pricing Transparency Law, which requires machine-readable, consumer-friendly files of payer-negotiated rates, gross charges, and discounted cash prices for 300 "shoppable" services. However, a recent study published in JAMA found that 13.9% of hospitals had a machine-readable file but no consumer-friendly display, 29.4% had a consumer-friendly display but no machine-readable file, and just 5.7% had both and were fully compliant with the law in its first year.
With so much information now available from health plans and hospitals, some consumer advocates are concerned that the size of the databases could make it difficult for individuals to access and understand the data.
"John or Jane User is not likely to start perusing millions of files," said Tim Brechtel, an attorney at Jones Walker who has worked with employers on the insurer price transparency rule. "In theory, that's the goal of this—to have (people) see what it costs for a given service. But I just don't know how many people are going to do it."
Industry leaders expect that will change, though, as entrepreneurs step in to reconfigure the data into user-friendly formats that can help estimate costs for patients. Once that happens, "you'll at least have the options in front of you," said Chris Severn, CEO of Turquoise Health.
"Clearly, both providers and payers have a critical role to play, and the healthcare industry as a whole must work together to holistically improve price transparency, which is a key piece of the puzzle to improving the overall patient financial experience," Beadle-Ryby said. (Asser, HealthLeaders Media, 7/22; AKASA press release, 7/21; Appleby, Kaiser Health News, 7/1)
Create your free account to access 2 resources each month, including the latest research and webinars.
You have 2 free members-only resources remaining this month remaining this month.
Never miss out on the latest innovative health care content tailored to you.