Pulling Back the Curtain: How Americans Use Health-Care Price Information.

• Author: Schleifer, David
• Position: Best Practices

State and municipal governments, private employers, and other purchasers of health care have long sought ways to control their health-care spending--including by asking insurance beneficiaries to pay higher deductibles, copayments, and coinsurance. These forms of cost sharing are designed to shift some costs to individuals and families, based in part on the assumption that it will force people to consider price in their health-care decision making.

However, the health-care system has generally not made it easy for people to find out how much their care will cost them out of pocket. In fact, non-disclosure agreements in contracts between health-care providers and insurers sometimes explicitly prevent public disclosures of price information. While many insurers, providers, employers, and state governments have been taking steps to improve price transparency, Catalyst for Payment Reform nonetheless gave most states grades of "F" on their efforts--or lack thereof--to make prices more transparent. (1)

Price transparency need not be designed or evaluated solely based on the goal of facilitating price shopping for individuals and families. (2) Employers, regulators, and journalists may want to use price information to hold hospitals and other health-care providers accountable for high prices. Physicians may need price information in order to have informed conversations with patients about the financial impact of a diagnosis or treatment plan. Individuals and families may simply want to know what their care is going to cost in order to avoid nasty surprises.

Public Agenda has conducted two national surveys focused on how Americans are trying to find and use health-care price information. (3) Both surveys explored attitudes about and experiences with health-care prices among nationally representative samples of American adults. (4) This article discusses findings from and implications of the second survey, results of which were released in 2017. (5)

SURVEY INFORMATION

Half of Americans have tried to find price information before getting care. But fewer have tried to compare prices.

Twenty percent of Americans have tried to compare prices across multiple providers before getting care. Approximately one in three Americans --28 percent--have tried to find out a single provider's price rather than comparing. (See Exhibit 1.)

Fifty-three percent of Americans who have tried to compare multiple providers' prices before getting care say they saved money, while only 28 percent of those who have tried to check one provider's price report saved money. (See Exhibit 2.)

Some health-care experts have expressed the concern that making price information transparent could actually lead people to choose higher-priced care...