For consumers, the price of care is often a mystery--but it shouldn't be.
Oftentimes, patients do not know the price going into their operation because it's difficult for providers to supply payer-specific price data without any information pertaining to the patient's benefit design.
This calls for greater price transparency across the industry. Top-name payers--UnitedHealthcare, Aetna and Humana--already are making headlines. Their price transparency initiative, organized by the Health Care Cost Institute, will provide consumers with a reference price for episodes of care, such as knee replacements and heart surgery, in different communities based on aggregated data from the insurers, FierceHealthPayer previously reported.
But these efforts may be easier said than done.
There are challenges on all ends of the spectrum. First, it's hard to engage consumers when prices remain hidden behind copayments and deductibles, notes the report. Secondly, it's important for payers and providers to negotiate prices, but such an act is difficult due to lack of competition among hospitals and other facilities.
So to improve price transparency, the report calls for implementation of an insurer-initiated price transparency program, which engages members through phone calls, uses real-time member profiles and emphasizes customer service. The idea is that with prompted intervention, members will select the lower-priced service.
The report's researchers presented consumers with plan alternatives to gauge which service the patients would select, based on price. They found that when they presented similar-quality but lower-price alternative services to members, the patients typically selected the lower-priced facilities.
Overall, the study suggests that a price transparency plan that involves member outreach can reduce healthcare costs.
- here's the study (.pdf)