Most insured Americans pay health care deductibles and coinsurance, with cost-sharing rates that seem to be continually increasing. At the same time, millions of uninsured people face unpredictable and often high charges for medical care.
In other words, Americans have a significant amount of “skin in the game” when it comes to health care. That said, it’s not easy for most people to find out how much their health care will cost—let alone to find lower-priced care. The opacity of health care prices is one major reason for this. Despite the fact that so many Americans must pay for so much of their medical care out of pocket, easy access to accurate price information remains far from routine.
This month, Public Agenda, with support from the Robert Wood Johnson Foundation, released the results of a national survey finding that 56 percent of American adults say they have tried to find out their out-of-pocket costs (excluding a copay) before getting the care they needed, or have tried to find out how much their insurance would pay a doctor or hospital. In other words, despite the opacity of price information, the majority of Americans have at least tried to find out how much their care would cost.
The survey also found that the majority of Americans do not believe that higher prices are typically a sign of better quality. Together, these findings suggest that Americans are open to looking for better-value care.
But just because people are looking for price information does not necessarily mean they are comparing prices. Looking more closely at the 56 percent of Americans who have tried to find out how much their care would cost, 33 percent of all Americans checked prices from just one provider, and only 21 percent of all Americans compared prices across multiple providers (for the remaining 2 percent, our survey could not determine whether they had checked or compared). However, the majority (62 percent) of those who did compare prices say they saved money by doing so.
So why aren’t more people shopping around? Our survey suggests one possible reason: a substantial number of insured (57 percent) and uninsured (47 percent) Americans are not aware that physicians might actually charge different prices to different people for the same services. Our follow-up interviews also indicate that people may not compare prices because they are unable or unwilling to change providers.
In our report, we highlight a number of recommendations for insurers, employers, policy makers, and providers who want to make price information more easily available to patients and families, including the following:
- Strengthen the capacity of providers, staff, and insurance company personnel to discuss prices. Some of the most common ways that people try to find price information are asking receptionists or other staff in their doctors’ offices, calling their insurers, and looking on their insurers’ websites. Enhancing the availability and quality of price information at these and other potential access points could help ensure that consumers are able to find out how much they will have to pay out of pocket.
- Help people understand that prices vary. Our survey found that many Americans are not aware that providers’ prices vary. While policy experts, price information vendors, and journalists have devoted considerable attention to health care prices, more can be done to help people better understand price variation.
- Help people understand how to find price information. Fifty percent of Americans who had never sought price information said they did not know how to find it. This suggests a need for more outreach and education about reliable sources of price information.
- Focus on people who care for others and on those who receive regular medical care. Americans who compare prices are more likely than others to be helping another adult family member make health care decisions or to be receiving regular medical care themselves. Those working to engage more people in comparing prices may therefore wish to focus on, and tailor their outreach and support to, caregivers and those getting regular care.
- Recognize the obstacles to seeking and comparing prices and to choosing better-value care. Follow-up interviews with survey respondents who checked but did not compare prices suggest that many people are not comparing because of issues of convenience, access, or trust. For example, one man insisted he would never consider going anywhere besides his local academic medical center where he feels comfortable, where he knows the doctors, and where his medical records are kept. One woman told us she did not compare providers’ prices for a surgical procedure because she felt the surgeon she had chosen was the only person in her rural area she trusted to do the procedure she needed. Some people may see comparing prices as a burden on patients. For example, a focus-group participant who had never sought price information felt that expecting people to compare prices would be yet another obligation in the already-confusing health care system. In fact, our survey found that 43 percent of Americans say it is not reasonable to expect people to compare prices before getting care.
While seeking out and comparing prices may not be appropriate for everyone or for every medical situation, many Americans are open to using price information to choose better-value care.
We invite you to dig into our full report and its implications here.