The healthcare industry has only partially adopted a consumer-focused approach to selling its services and "there is a competitive need for providers to get transparency right, in terms of what information to present and through which channels," says one industry analyst.
Driven in part by high deductibles, Americans are increasingly looking at their healthcare choices in the same way they shop for other commodities, comparing prices and quality to get the most for their money.
Part of the answer lies in how the healthcare community has only partially adopted the consumer approach to selling its services, says Jean-Pierre Stephan, head of customer relationship management at Accenture, the multinational consulting company with a strong presence in healthcare. If healthcare organizations are going to use a more traditional business approach by providing prices and quality information, they have to fully embrace it and solicit participation, Stephan says.
"There has to be a trigger for the consumer to change behavior," Stephan explains. "Just having information out there, thinking patients will come to the information because you're transparent and it's there, is not how other industries have solved consumer behavior problems. That is why we're seeing low adoption rates with these solutions."
That view is supported by an analysis of a large national health insurance plan database by researchers from Harvard T.H. Chan School of Public Health, which shows that only 3.5% of those who had access to Aetna's pricing tool, called the "Member Payment Estimator," used it in between 2011 and 2012.
Though participation probably has increased in the ensuing years, the figure still would be quite low today, says lead author Anna Sinaiko, PhD, research scientist in the Department of Health Policy and Management.
Sinaiko points out, however, that a price estimating tool will be useful only to a subset of the overall population that has access to it. Only patients who are planning for a healthcare service that has pricing information available will use the tool. That subset is much higher than 3.5% of all Aetna customers, so the figure still indicates low participation, she says. The Aetna tool covers more than 600 procedure bundles.
The researchers found that colonoscopies, mammograms, and childbirth services are the most searched-for medical services in cost estimators. Other top searched-for services in the study included MRIs, vasectomies, physician office visits, and other non-emergency services, according to a recent study in Health Affairs.
Profile of a Price Shopper
Most of the healthcare price information people sought was for "shoppable" services, the type that patients can plan for ahead of time, such as preventive screenings or outpatient procedures such as knee replacements, tonsillectomies, or hernia repair.
Most who used the price transparency tool were in the 19 to 34 age range, healthier than the general population, and had higher annual deductible spending than those Aetna members who did not use the estimator. Women used the tool more than men.
Gregory A. Freeman is a contributing writer for HealthLeaders.