Health plans can do more to improve price transparency for consumers, survey finds

Despite rising availability in online transparency tools, consumers remain unsure about costs and avoid care as a result, a new survey has found.

The annual consumer sentiment survey was conducted in January 2022 by Healthsparq, a health tech company, and reached more than 1,000 insured Americans. Transparency tools were defined as those provided by payers such as in-network provider search, cost estimates and information on treatment. 

The majority (70%) of respondents knew that their health plan offered these, up from 49% last year, and most had used them in the past year. They also said this access helps them better understand their coverage and manage costs. Yet nearly half reported avoiding care due to unclear costs, up from a quarter last year. Care avoidance was even more pronounced among those under the age of 34, at 63%. 

Mark Menton, Healthsparq’s general manager, told Fierce Healthcare he suspects that is because the tools exist, but consumers do not know how to access the information.

“I think that’s a hurdle we as an industry need to overcome,” Menton said. “They don’t know where to find this information.” 

Provider search was found to be the most widely available tool, followed by telehealth and selecting a primary care physician online. The top five most important factors for consumers are whether the doctor is in-network, distance, years of experience, appointment availability and cost. Most wish their plan offered more in-depth provider profiles, and a third discovered inaccurate information on their plan website. 

“Developing better approaches to provider data updates is key for improved member experience and compliance going forward,” the report said. 

Though federal mandates around price transparency are a good first step for consumers, plans should build on that to help members understand their coverage and costs. In fact, just having a price list “enhances the problem because people don’t know what to make of it,” Menton said. “It’s just going to create more chaos and more confusion.”
Health plans are uniquely positioned to help consumers with this because of their access to data. And even though few consumers know the federal government will soon require plans to provide cost estimates to members for all covered services, most (81%) support this requirement. 

“How do we increase awareness and reduce friction of getting access to the information? I think we need to pull both levers to really have an impact,” Menton said.