Purpose: In response to ever-increasing health care costs and the lack of cost-sensitivity by many patients, self-insured employers are shifting to consumer driven high-deductible health plans. There has been a proliferation of tools to help support the medical decision making needs of this population. We evaluated the effects of a price transparency tool on medical expenditures among patients on high-deductible plans.
Methods: We prospectively evaluated the health care utilization of a cohort of patients in northern California (n=3007) with health plan deductibles >$1000 between June 1 2010 and December 31, 2010. All participants had access to an easy to use, cost transparency tool that provides patients with their personalized out-of-pocket costs for healthcare services. The tool was provided at no cost to the participants and no additional incentives were provided to encourage its use. We defined searchers as participants who used the tool to find at least one price for a healthcare service. We further defined active searchers as participants who searched for and then received the corresponding medical service. We compared the healthcare utilization of searchers and non-searchers using t-tests.
Results: 17.8% (n=534) of participants used the tool to search for a medical service. Searchers tended to be more likely than non-searchers (n=2473) to be women (58% vs 43%; p=0.11) and to be older (45% > 60 years vs 40% > 60 years; p=0.22). For selected high-cost procedures, searchers received lower cost alternatives than non-searchers; PET withCT scan ($450 vs $822), CT scan of the chest ($213 vs $362), and MRI of the breast ($450 vs $822), although none of these were statistically significant differences. Similarly, active searchers had higher total annual spend per person ($1308) than non-searchers ($750).
Conclusions: Patients who search for cost information may be more likely to obtain lower-cost services than patients who do not seek this type of information. This suggests that people who bear a heavier burden of their healthcare costs have more incentive to shop to reduce them. Price transparency tools may be an innovative means to control medical expenditures; however, incentives may be necessary to encourage their use.
See more of: The 33rd Annual Meeting of the Society for Medical Decision Making