The majority of health plans in the U.S. offer price transparency tools to consumers, nearly all of which include estimates for common surgical procedures, radiology services, and out-of-pocket costs, according to a survey published in the American Journal of Managed Care (AJMC).
The survey, conducted by America's Health Insurance Plans (AHIP), included responses from 43 health plans contacted between 2014 and 2015. Of those, 31 plans provided price estimator tools, and nearly half of the plans that did not have price estimator tools planned to implement them within the next 12 to 24 months.
Eighty percent of plans that offered estimation tools based their selection on common procedures and services. Nearly every plan included estimates for elective outpatient surgery, radiology services, and inpatient surgery. Fifty-eight percent of plans included cost estimates for prescription drugs and 90 percent outlined out-of-pocket costs for specific procedures.
However, researchers also noted that simply making cost estimation tools available does not mean members are likely to use them, and further research should look at ways of displaying pricing data that leads to better engagement and comprehension among beneficiaries.
Although price calculators are gaining popularity among consumers, some have expressed concerns about the accuracy of those estimates. Still, previous research has shown that when customers have access to pricing information, claims payments for common medical procedures go down.
Last year, AHIP released recommendations for price transparency tools, urging health plans to include quality data alongside cost information and develop actionable, consumer-friendly data without providing "competitively sensitive information."
To learn more:
- see the AJMC study