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Healthcare Consumers Lack Transparency, Price Info Awareness

By Jacqueline DiChiara

- Many obstacles impede healthcare consumers from acquiring high quality healthcare. Many healthcare consumers are unaware of the idea of price transparency. Still, many healthcare consumers yearn for more information about the cost of their healthcare, confirms Public Agenda’s research from David Schleifer, PhD, Senior Research Associate, Carolin Hagelskamp, PhD, Vice President and Director of Research, and Chloe Rinehart, Research Assistant.

price transparency

Schleifer spoke with RevCycleIntelligence.com about the greater implications of what the survey of over 2,000 adults mean and how to address the challenge of providing healthcare consumers with valuable information about price transparency and cost awareness.

“The big overall finding is that 56 percent of Americans had at least tried to find out price information before getting care,” says Schleifer, referring to nearly 40 random survey respondents. “Within that 56 percent of people who tried to find price information, 33 percent of them had only checked one price and 21 percent of them had actually compared multiple prices. I think that's significant if the idea of price transparency is that people will shop around,” he states.

Schleifer says those individuals who compared prices were much more likely to claim they had saved money. Schleifer confirms pinpointing why individuals seek price information or their objectives for doing so is challenging. The data may be interpreted as “qualitative stories,” he says, as there was variation among those who checked prices without making financial comparisons.

I think the point you may want to make here is people who have compared prices are more likely to be aware of price variation than people who just checked one price and even moreso that people who have never sought price information, since maybe your readers can be part of helping people to understand that price vary.  Price transparency’s limitations are hypothetically present, infers Schleifer.

Research conducted raises questions –If those living in rural areas face a more limited choice when choosing physicians and hospitals, are they more or less likely to actively consider price? Are those who are comfortable with a certain physician or hospital less likely to be solely swayed by matters of price?

Additionally, Schleifer confirms most healthcare consumers do not necessarily equate high cost with high quality. “When we asked four different ways, we found most people just don't think that's true,” he says. “That seems like good news, but I don't know what it means in terms of marketing or advertising whether or not your price is lower than someone else's.” The benefit of such, says Schleifer, is that hospitals should not worry about consumers associating cost with quality.

Another facet of the information collected relates to healthcare consumers’ price awareness levels. “One thing we know quantitatively from the survey data is people who have compared prices are more likely to be aware that prices can vary than people who just checked one price,” says Schleifer. “We don't know if they are aware of price variation and therefore were comparing prices, or if they went out comparing prices and therefore learned that prices vary. But there's definitely an association between comparing prices and awareness of price variation because most Americans overall don't know that prices vary,” he says.

The most common reported source regarding where consumers were getting their price information and sources from involved old-fashioned word-of-mouth: friends, relatives, and colleagues.

The second most common consumer source for price information was recipients or office staff, Schleifer maintains. “If people are asking the receptionist or the staff in their doctor's office for price information, that suggests hospital executives might want to think about how to equip receptionists and office staff to be able to answer people's questions about access to price information or how to direct them elsewhere,” says Schleifer.

“A lot of people were calling their insurance company or looking on their insurer's website,” he explains, referencing the 46 percent of those surveyed who confirmed contacting their insurance company by web or phone. Similarly, 46 percent of those surveyed also confirmed acquiring price information before getting care from a doctor. “Word of mouth thing doesn't necessarily have to be a bad thing,” says Schleifer. “If the office staff are the trusted source of information, it makes sense.”

Healthcare consumers’ support and hunger for price transparency is strong as long as healthcare providers are willing to provide price information, especially as deductibles rise, says Schleifer. “About 69 percent of people say insurers should make prices public for medical services. People want this information. Even people who had not ever tried to find price information, most of them said they would like that information if they could get it. A lot of people said they would choose a less expensive doctor if they knew prices in advance,” confirms Schleifer.

Schleifer also considered how insurance status and size of deductibles were associated with price information. “We found that having a deductible over $500.00 meant people were more likely to seek price information,” he says. “People who are uninsured are more likely to seek price information and people with deductibles over a certain amount are more likely to seek price information.” 

“People who were receiving regular medical treatment were more likely to compare prices, and people making medical decisions for another adult family member,” he says. “If people are trying to figure out who's going to be the most eager audience for price information, it makes sense it's people getting the most care who are going to be most in need or most likely to look for it and people who are helping to care for someone else,” he explains. 

In terms of the price transparency/demographics connection, there are noted similarities and differences in regard to education levels, gender, and employment level. “While 56 percent of Americans overall have sought price information, we found 62 percent of those with college degrees have done so, as opposed to 54 percent of those without degrees,” says Schleifer. “In addition, 59 percent of women versus 53 percent of men have sought price information. Moreover, while 62 percent of employed Americans have sought price information, the same can be said of only 55 percent of unemployed Americans and 40 percent of retired people,” researchers confirm.

“While 21 percent of Americans overall have compared prices across multiple providers before getting care, we found 35 percent of Hispanics and 24 percent of African Americans have done so, compared with only 17 percent of whites. We also found 33 percent of people under age 30 as well as 20 percent of people ages 30 to 64 have compared prices, versus only 9 percent of people ages 65 and older,” researchers state. “Among Americans with total household incomes of $100,000 or more, 16 percent report having compared prices across multiple providers before getting care, while 22 percent of people with annual household incomes of less than $100,000 say they have done so,” they add.

Most individuals lack awareness of the fact that prices vary, Schleifer confirms. “Not only is that significant in itself, but it really speaks of this gap between what healthcare policy and practice experts know and think about all day long and what most Americans actually know,” he says, adding that even though trade media coverage discusses price variation actively, most healthcare consumers still lack awareness. 

Nonetheless, prospects for future change to increase price transparency awareness among healthcare consumers are momentous, says Schleifer. “It represents a real opportunity to help educate people about price variation and potentially help them make choices that save them money. It may be something that gets built into price information systems.  It may be something that doctors and nurses and receptionists are able to help educate people about. I don't know what the channels are but there's some work to be done.”