Practice Management News

Most Healthcare Consumers Do Not Research Pricing Options in Advance

More than half of healthcare consumers said they have never looked at pricing options for care but would consider shopping around if prices were disclosed ahead of time.

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Source: Getty Images

By Victoria Bailey

- Most healthcare consumers do not typically research different pricing options before receiving healthcare services, indicating the need for greater price transparency, according to a survey from YouGov, commissioned by AKASA.

The survey reflected responses from 2,026 Americans gathered online between March 9 and March 14, 2022.

When asked about seeking out pricing for healthcare services, 64 percent of respondents said they have never tried looking for prices for care or services that they needed.

Younger adults between 18 and 34 (45 percent) were more likely to research prices for healthcare services compared to adults 55 and older (27 percent). Researching healthcare prices ahead of time was also more common for consumers with high-deductible health plans (HDHPs) and individual plans (43 percent).

In addition, 58 percent of respondents said they would be encouraged to shop around if pricing information was disclosed before receiving healthcare procedures and services.

“There's clearly a gap between what many healthcare organizations - providers and insurance companies - think helps increase price transparency and the experience of patients in finding price information conveniently and in a manner that is easy to understand,” Amy Raymond, vice president of revenue cycle operations at AKASA, said in the press release.

“This is a deterrent for patients in seeking out the best price like they would in any other industry, which can be incredibly frustrating.”

The lack of awareness about publicly available pricing information and limited transparency from providers may be preventing consumers from receiving the most affordable care. Better price transparency in the healthcare industry could help inform patients of all of their options before receiving healthcare services.

The hospital price transparency rule, which went into effect on January 1, 2021, requires hospitals to publicly publish the standard charges for their items and services. However, compliance with this regulation has been lacking.

Only 16 percent of 2,000 hospitals achieved full price transparency compliance, according to data from August 2022.

CMS has started sending penalties to facilities that are in violation of the rule. Two Georgia hospitals received hefty fines for failing to comply with the machine-readable file and shoppable services requirements of the regulation.

However, hospitals and providers are not the only stakeholders with price transparency responsibilities. As of July 1, 2022, the Transparency in Coverage rule requires payers to post pricing information for covered items and services.

A separate YouGov survey commissioned by AKASA found that, among consumers who research prices for healthcare services, 60 percent said they would look to their health insurance companies for pricing information. Nearly half (44 percent) said they would look on the insurer websites and 29 percent would call their insurance company.