Patients may need more of a nudge to capitalize on price transparency

Price transparency may be one of the few initiatives that will allow the U.S. healthcare system to save itself from itself. But there is a growing body of evidence suggesting that its existence may not make a bit of difference.

The most recent nugget of that is a study recently published in the Journal of American Medical Association. It studied 148,655 individuals whose employers offered them a tool that calculated out-of-pocket costs for a variety of healthcare services. Their habits were then compared against a control group of 295,983 employees.

The findings were hardly heartening: Mean outpatient spending among the group with the price transparency tools was $2,021 in the year before the tools were introduced. In the year after it was introduced, the mean rose to $2,223.

"Offering a price transparency tool was not associated with lower healthcare spending. The tool was used by only a small percentage of eligible employees," the study authors concluded.

Given the enormous cost-shifting that has been going on to individual enrollees over the past 15 years, you would think there would be more uptake in this area. But there really hasn't been any sort of uptake.

There hasn't been much research in this particular area, but I would venture to guess that many consumers remain overwhelmed by the financial complexities inherent in healthcare delivery. They probably think that shopping around is one of those situations where it would require six hours of a work just to save a couple of bucks, and that the only person who could benefit is one of those maniac coupon clippers who hasn't actually paid for their groceries since 1983.

That's not necessarily true, as many of those price transparency calculators offered by health plans for their enrollees are pretty sophisticated, and given the bottom line-driven mentality of the insurance sector, fairly altruistic (that the providers are the ones who receive the co-payments may have something to do with this).

Consumers eventually are going to have to get over their hesitancy to use such tools, although payers may have to nudge them in that direction.

The best action that payers could take is to offer some form of financial incentive for enrollees to use their tools--and maybe to even use one of those tools that are available from a variety of third-party vendors. A 5 percent discount on their out-of-pocket costs--perhaps initially absorbed by the insurer rather than the provider--would be a start. Or maybe gift cards or something else along those lines.

And while I am certain they would be reluctant to do so, hospitals and other providers are eventually going to have to join this push as well. Patients and their families need a break on their bills, and the more pressure they feel as a result of their rising out-of-pocket costs, the more likely they are to opt out of getting insurance coverage altogether. That would mean a rise in uncompensated care. It's simply a wiser long game to give patients a financial boost they sorely need. – Ron (@FierceHealth)