Most Americans with high-deductible health plans don't shop for care: 5 things to know

Few Americans with high-deductible health plans are comparing prices when accessing healthcare treatment, according to a recent study published in JAMA Internal Medicine.

For the study, researchers — led by Jeffrey Kullgren, MD, of the VA Center for Clinical Management Research at VA Ann Arbor (Mich.) Healthcare System — surveyed 1,637 adults enrolled in HDHPs for at least a year. The survey, conducted from Aug. 26, 2016 through Sept. 19 of the same year, asked participants if they had put away money for health services, price shopped or compared quality ratings for a service, spoken with a provider about the cost of a service, or tried to negotiate the price of a service down in the past year.

Here are five findings from the study.

1. The majority, or 84 percent of respondents, were employed and had employer-based health insurance. Other characteristics of the survey sample are 42 percent had a chronic condition and 58 percent had an account set aside for medical bills, such as a health savings account.

2. When asked about their consumer behavior when accessing healthcare services, 40 percent of HDHP policyholders said they saved for future healthcare expenses. Twenty-five percent of participants spoke with a provider about the cost of a service, and only 14 percent compared prices and quality ratings. Six percent tried to negotiate the price of a service, the study found.

3. Respondents cited two healthcare purchases — prescription drugs and outpatient visits — as the most common services for which they engaged in consumer behavior.

4. While few respondents with HDHPs engaged in consumer behavior when accessing healthcare services, those who did realized more benefits, the authors stated.

5. The researchers offered the following ways providers, employers and payers can encourage healthcare consumerism among HDHP policyholders:

"Health systems could make prices for services available at the point of care to facilitate patient and clinician conversations about cost. Employers and insurers could go beyond disseminating price information to help patients learn how to use this information in health care decisions." They explained, "Such efforts will become increasingly important as enrollment in HDHPs continues to increase and could become essential if modifications to the structure or implementation of the Affordable Care Act accelerate patients' exposure to high cost sharing." 

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