4 reasons patients struggle to shop for healthcare

A committee of Montana lawmakers met for the first time Wednesday to find solutions for consumers looking for the best healthcare deals. Gisele Grayson, a health editor at NPR in Washington, D.C., explored reasons patients struggle to find transparency in healthcare pricing in an interview with Montana Public Radio.

Here are four reasons patients struggle to shop for healthcare, according to the report.

1. Insurance companies negotiate prices with hospitals and medical offices and decide whether to pass savings on to patients or keep higher profit margins. As a result, it is difficult for insurance companies to create a standard tool for negotiating prices, Ms. Grayson said. For example, insurance companies might negotiate a good price for a common medical procedure at a small hospital, but might not get the same price for the same procedure at a big hospital with a better reputation. At these hospitals, insurance companies pay what hospitals ask because the majority of their customers will want to go there.

2. "A lot of us are on the hook for a lot more of our healthcare than we used to be, no matter what kind of insurance we have," Ms. Grayson said. Although companies are trying to make transparency tools to shop for healthcare, they are still in the very early stages, Ms. Grayson added. Additionally, Ms. Grayson noted research shows many consumers do not use existing transparency tools, and it is unclear why.

3. Only approximately 18 states have set up databases to compile as much information healthcare pricing information as possible, but governments cannot require companies that operate across state lines to reveal what they're paying, Ms. Grayson said.

4. Efforts to make healthcare shopping tools lack quality data. "There's the assumption that if you're paying more you're getting more, that's not often true in healthcare," Ms. Grayson noted. "The price information is useful, but it's crowdsourced, so it's not comprehensive." In this way, consumers may not be able to get as low of a price based on their insurance and may find errors in the data due to mistyped numbers.

More articles on patient engagement: 
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Patient satisfaction declines when hospitals have fewer nurses: 4 findings

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