The call for healthcare pricing transparency is growing stronger as the nation struggles to control rising healthcare costs. A new study published in JAMA reports that patient awareness about pricing related to services before they were used resulted in lower claims payments for 3 common medical services – diagnostic laboratory tests, advanced imaging services, and clinical office visits.
On examining medical claims from 502 949 patients from 2010 to 2013, the researchers confirmed that when an employer-sponsored private price transparency platform is used prior to receiving services, it resulted in lower overall payments made for clinical care. The study revealed that
- With access to the price transparency platform, 5.9% of laboratory test claims, 6.9% of advanced imaging claims, and 26.8% of clinician office visit claims were linked to a prior search on the platform
- Before having access to the price transparency platform, searchers had higher claims payments than nonsearchers for lab tests, higher payments for advanced imaging services, and no difference in payments for clinician office visits
- With access to the price transparency platform, searchers had comparatively lower relative claim payments than nonsearchers
- Overall, those who made use of the platform to search for services paid $3.45 less for laboratory tests, $124.74 less for advanced imaging services, and $1.18 less for clinician office visits
According to the researchers, the reason why claim payments fell is probably because providers were forced to reduce prices with the widespread use of price transparency platforms by employers. They concluded that the change in the behavior of providers and patients could have a substantial impact with greater transparency in healthcare pricing reducing medical costs by as much as 14%.
Last year, another study by researchers at John Hopkins suggested that if hospitals provided physicians with information about the price of some diagnostic laboratory tests at the time the tests were ordered, this could prompt them to order substantially fewer tests or look for alternatives that cost less. They found that transparency in price information resulted in a decreased overall use of tests by about 9 percent.
The practice of keeping both patients and providers uninformed about the cost of medical services is one of the main reasons for the spiraling cost of healthcare in the U.S. The solution obviously lies in pricing information transparency by providers and comparison shopping by consumers and physicians.