It’s not uncommon for the average healthcare consumer to be in the dark when it comes to the value of services received. We’re typically oblivious to the cost and quality of each service until the bill arrives or something goes wrong ― like when a revision to a hip replacement is necessary. And such blind faith can be a significant driver of rising healthcare costs.
Recent legislation is putting more emphasis on price transparency in hopes it will lead to increased consumerism and, in turn, more value. Many employers have followed similar logic and purchased consumer tools from their insurance provider or a third-party service.
However, on a recent episode of the Relentless Health Value podcast, Sunita Desai, PhD, argues that the “silver bullet” of price transparency has no effect in reducing spend. A health economist and assistant professor at NYU’s Grossman School of Medicine, Desai finds that these price transparency tools tend to have low utilization and poor results when it comes to reducing spend.
We’ve seen this play out firsthand with our own clients. Why? Armed with knowledge and appropriate information at their fingertips, what’s preventing plan members from seeking the lowest cost, highest quality providers for shoppable services like an MRI or knee replacement?
Desai points out a number of roadblocks to broader utilization. Some of these platforms are simply not user-friendly and lack sufficient incentives to price shop. Desai also believes many make the mistake of overlooking providers and should be supplying physicians with price information at the point-of-service in hopes they will include cost of care when discussing treatment. But is that really practical ― especially in an era where most physicians are employed by health systems?
Of course, frequent communication can also prove a key factor in plan member use of such tools. A price transparency tool is not a “build it and they will come” proposition. Which leads to the question of whether the cost of the tool and its promotion more than offsets the practical value of its use?
It is hard to argue against the value of greater price transparency in healthcare, but it’s likely not enough to change the economics of our system. Giving consumers the insight and tools to make educated decisions regarding the value of various services is of equal or greater importance.
Maybe the better strategy is to first teach plan members (conceptually) about the things they can do to help reduce healthcare costs. Maybe you, as the plan sponsor, can even help steer them in the right direction for common services. If you think, “I’m not qualified to do that,” then you may appreciate some of the difficulties your plan members face. We would argue that you are (at least with the help of your advisor) probably better qualified than your members.