US healthcare consumers find little information online

Our findings suggest that there is substantial room for improvement in providing consumers with ready access to health care prices online. Policy makers should consider mandating that payers and providers make these prices available to consumers. – Allison Kratka

Is Real Free-Market Health Care Even Possible? Lyne Lucien illustration, The Daily Beast

Duke University December 4, 2017

Trying to be an informed healthcare consumer in the United States is harder than you might think, according to researchers from the Duke-Margolis Center for Health Policy. When consumers search for healthcare prices online, only 17 percent of sites provide information on the price of common procedures, making it difficult for patients without insurance, who have high-deductible plans, or whose plans include other kinds of cost sharing to determine how much their care will cost and what they will pay out of pocket.

The study’s conclusions, published today as a research letter in JAMA Internal Medicine, are based on a systematic internet search using two search engines (Google and Bing) for the prices of four non-emergency medical procedures in eight cities:  New York, Los Angeles, Chicago, Seattle, Baltimore, Charlotte NC, Manchester NH, and Tallahasee FL. Researchers searched, and then repeated searches for validation, based on a fixed set of search terms focused on prices for a cholesterol panel lab test, a brain MRI, a hip replacement surgery and an upper gastrointestinal endoscopy.

The team then reviewed the resulting websites, and found that just over one fifth were focused on price transparency. When consumers are able to find sites that list geographically-relevant prices, they can vary widely and do not specify whether the price quoted was the consumer’s out-of-pocket cost – for example, in Chicago, sites listed costs from $25-100 for a cholesterol panel, $230-1950 for a brain MRI, $875-3958 for an upper GI endoscopy and $27,000-80,671 for a hip replacement.

“Our findings really underline how difficult it can be to find the information patients need to be informed consumers,” said fourth year medical student, Allison Kratka, who was first author on the study. “It is labor intensive to find the sites, many require subscriptions, and the reliability of the pricing information contained in the sites is difficult to assess.”

“There is a disconnect between policies that seek to encourage people to be smarter consumers and the availability of information that allows them to make the most cost-effective decisions,” said Peter Ubel, MD, Madge and Dennis T. McLawhorn University Professor at Duke University’s Fuqua School of Business. “A handful of states, like New Hampshire, support and market price transparency web sites, and policy makers who want consumers to participate in controlling costs need to ensure that prices are available to the average person.”

Other study authors include Charlene Wong, MD, MSHP, Riley Herrmann, Kathryn Hong, Aleena Karediya, and Iris Yang, all of Duke University. Drs. Wong and Ubel are members of Duke-Margolis and Dr. Wong holds faculty appointments in the Duke University School of Medicine, Department of Pediatrics, and the Duke Clinical Research Institute.

Source Duke University


Finding Health Care Prices Online-How Difficult Is It to Be an Informed Health-Care Consumer? Kratka A, Wong CA, Herrmann R, Hong K, Karediya A, Yang I, Ubel PA. JAMA Intern Med. 2018 Mar 1;178(3):423-424. doi: 10.1001/jamainternmed.2017.6841. Full text

Debunking common myths about healthcare consumerism [in the US]

Jenny Cordina, Rohit Kumar, and Christa Moss, McKinsey & Company December 2015

As consumers take an increasingly active role in healthcare decision making, payors and providers need an accurate understanding of how healthcare consumerism is playing out. Using data from surveys of thousands of people across the U.S., we debunk eight of the most common myths circulating in the industry.

Until recently, consumerism in the U.S. healthcare industry has moved slowly. However, several converging forces are likely to change the situation soon and result in a more dynamic market. Higher deductibles and co-payments, greater transparency into provider performance and costs, and the rise of network narrowing and provider-led health plans are prodding patients to become more involved in healthcare decision making than ever before.

As yet, most payors and providers have comparatively little data to assess how consumerism is likely to affect them. As a consequence, they can neither confirm nor refute a number of assumptions about healthcare consumerism that are often stated as fact.

Over the past eight years, we have conducted extensive research into healthcare consumerism. This year alone, we surveyed more than 11,000 people across the country about how they perceive their healthcare needs and wants, how they select providers, and how they make other healthcare decisions. Our results suggest that many of the assumptions currently being made about healthcare consumerism are no more than myths.

Source McKinsey & Company


Debunking common myths about healthcare consumerism, PDF, Jenny Cordina, Rohit Kumar, and Christa Moss. McKinsey & Company. Healthcare Systems and Services Practice. 2015

Hospital networks: Evolution of the configurations on the 2015 exchanges, Noam Bauman, Jason Bello, Erica Coe, and Jessica Lamb. McKinsey Center for U.S. Health System Reform. Intelligence Brief April 2015.

A census of state health care price transparency websites, Kullgren JT, Duey KA, Werner RM. JAMA. 2013 Jun 19;309(23):2437-8. doi: 10.1001/jama.2013.6557.

The Transparency Imperative, Robert P Kocher MD, Ezekiel J Emanuel MD PhD. Ann Intern Med. 2013;159(4):296-297. DOI: 10.7326/0003-4819-159-4-201308200-00666

Also see
Top 5 Commercial Insurers Increasingly Rely on Public Programs Medscape
If prices are kept hidden, consumers can’t take more responsibility for their health care costs STAT
Most People Not Bargain Hunters When It Comes to Health Care HealthDay
How Real is Healthcare Consumerism? Health Leaders
Is Real Free-Market Health Care Even Possible? The Daily Beast
Here’s What The CVS-Aetna Merger Says About The Future Of Healthcare Clinics Fast Company

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