Do patients choose lower-priced facilities after checking procedure prices?

Providing patients with transparency tools that provide price information can help them identify lower-cost services and ultimately reduce healthcare spending, a study recently published in JAMA found.

When payers provide patients with price information as well as insurance benefits for choosing lower-cost facilities for care, patients often choose the less expensive option. However, it has remained relatively unknown whether transparency tools alone could yield similar results.

In this study, researchers examined the effect of Aetna's web-based, real-time, personalized episode-level price transparency tool on patients' choice of healthcare facilities for eight services. The tool is offered to 94 percent of commercial enrollees, and of these, about 3.5 percent use the tool and constitute the study sample.

Here are five things to know about the study and its findings.

1. Patient choices on healthcare facilities were evaluated for carpal tunnel release, cataract removal, colonoscopy, echocardiogram, mammogram, several magnetic resonance imaging and computed tomographic imaging services, sleep studies, or upper endoscopy during the period 2010 through 2012.

2. To isolate the effect of viewing prices for a procedure on a patient's selection, researchers compared whether patients who viewed price estimates for their procedure prior to undergoing it were more likely to choose a lower-priced healthcare facility than those who used the tool for other procedures, or who underwent the procedure in the baseline year before the tool was broadly accessible.

3. The price transparency tool used the healthcare facilities' price estimates.

4. The study found male patients used the price tool most frequently. Additionally, it found patients who viewed price estimates before undergoing their procedure chose healthcare facilities with lower relative price estimates than other patients for imaging services and sleep studies.

5. There are some limitations on the study, including that it focused on only one carrier and the data included only the first two years the tool was available. The authors conclude more research is needed to determine whether these patterns hold true when the tools are used more broadly.

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