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Many patients are surprised to learn the cost of their health care procedures. Credit: 9dream studio / shutterstock.com
Imagine that there is a store where there was no price on the items, and you never knew what you would pay before choosing your purchases and left the store. You might be skeptical about the store's incentive to offer reasonable prices.
This exact situation has become the norm in health care in the United States, at least for people who do not have public health insurance. Meanwhile, US health care prices are, in many ways, the highest in the world.
Hospitals have resisted price disclosure, prompting policymakers to consider laws that require price transparency. This problem has become increasingly urgent as patients face additional and increasing costs. In addition, prices vary considerably from one hospital to another. The same MRI of a lower limb can cost $ 700 in one hospital and $ 2,100 in another. This means that significant potential savings could be realized if patients opt for less expensive options.
On January 1, there was a small step in that direction, as all US hospitals had to post their selling prices. However, the list of more than 15,000 procedures is notoriously incomprehensible, even for health professionals. What is a "HC PTC CLOS PAT DUCT ART", a procedure listed by a Tennessee hospital? Perhaps more importantly, the fees that patients pay for their patients often depend on the specifics of their insurance plan and the prices negotiated by their insurer, which means that the prices quoted do not correspond to what they are. They really paid.
For these reasons, many researchers and commentators, including myself, feel that it is unlikely that this approach will have a significant effect on health care costs.
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Tools that patients can use
This does not mean that price transparency is hopeless. Recent research shows that price transparency tools that contain useful and easy-to-use information can benefit patients and reduce healthcare costs.
Concerned about rising health care costs, employers have begun offering tools containing personalized information, helping employees compare prices paid. A study by Ethan Lieber at the University of Notre Dame found that patients who use Compbad, one of these price transparency tools, save 10 to 17% on medical care. A separate study of a similar tool, Castlight, also highlighted that the use of this tool resulted in substantial savings.
Given the limited availability of these tools, some states have tried to move forward on price transparency accessible to all. New Hampshire offers a particularly well-designed website that provides all insured patients in the state with personalized price information, allowing them to easily determine which options are low cost.
In an upcoming study, I badyzed the effects of this website with the help of detailed data on claims of the state. I found that the website not only helped some patients to choose less expensive solutions, but also resulted in lower prices that benefited all patients, including those who did not use the website.
<div data-thumb = "https://3c1703fe8d.site.internapcdn.net/newman/csz/news/tmb/2019/1-whatwouldhap.jpg" data-src = "https: //3c1703fe8d.site.internapcdn. net / newman / gfx / news / 2019/1-whatwouldhap.jpg "data-sub-html =" Even though each patient can save hundreds of dollars by comparing prices, these tools are not yet widely used by patients. Credit: toodtuphoto / shutterstock.com">
Although patients can save hundreds of dollars by comparing prices, these tools are not yet widely used by patients. Credit: toodtuphoto / shutterstock.com
Although each patient can save hundreds of dollars by comparing prices, these tools are not yet widely used. In addition, prices are often only available for a small number of procedures. As a result, overall cost savings are currently very modest. When I reviewed the medical imaging procedures in New Hampshire, I found an overall saving of about 3% for patients and insurers. However, the savings appear to be increasing as more people use the website and hospitals lower their prices accordingly.
Imagine a transparent system
Employer tools and state price transparency websites are a first step, but one could imagine going much further. Hospitals and insurers may be required to publicly disclose rates negotiated with insurers, which would allow governments and individuals to design innovative websites and applications with accurate price and font data. d & # 39; insurance. At the present time, states such as New Hampshire use the prices of medical expense claims from previous years to forecast current prices.
Hospitals may also be required to provide a detailed estimate – with a unique number summarizing the actual price paid by the patient – before making an appointment. With the exception of a few medical procedures, such as emergency services, I see no practical reason why billing can not be determined before a procedure rather than after.
Finally, it is important to note that even the best-designed price transparency initiatives are unlikely to reduce health care costs if there is not enough competition between hospitals. What good is knowing the price if a patient does not have other options? Hospital mergers have continued at a rapid pace, and researchers expect these mergers to often drive up prices by reducing competition.
If health care is to be left to the market forces, I believe that these markets must be transparent and competitive. Controlling health care costs will require bold solutions that lift the price cap.
Need hospital care or tests? Some ways to obtain cost estimates
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What would happen if American hospitals openly share their prices? (2019, January 30)
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