Patients Fail to Price Shop - Despite High Deductible Plans

Historically, the purchasing and financial decisions for healthcare services were made at the “wholesale” level with arrangements between the payers, providers, and the employer; with the patient glaringly absent. With the introduction, and subsequent mass adoption, of High Deductible Health Plans (HDHP) the patient now has “skin in the game” assuming more of the financial responsibility for their healthcare needs.

With more ownership of their healthcare decisions, it was generally assumed that patients would price comparison shop to find the best, and cheapest services for their medical needs and healthcare would become like any other consumer market in the United States.

A new study released by JAMA Internal Medicine, says that’s not the case. Researches questioned nearly 2,000 respondents, 1,099 of which had HDHPs, on the factors they considered when making healthcare choices. What they found was that even when people were responsible for more of their health costs, they weren’t more likely to consider cost or shop around for the best deal on medical treatments. In fact, only 4% of respondents said they compared costs.

The study cites barriers to price transparency as a reason why more patients are not price shopping. 56% of respondents with HDHP said they would use additional sources of healthcare pricing information if they were available as did 50% with conventional coverage.

“There is a big incentive for consumers in high-deductible health plans to price shop,” said Neeraj Sood, a co-author on the research letter and director of research at the Leonard D. Schaeffer Center for Health Policy and Economics at the University of Southern California. “[However], consumers’ ability to comparison shop remains relatively difficult.”

Sood called on policymakers to take steps to make pricing information more readily available for patients. “Skin in the game or financial incentives are not enough. We need to make it more convenient. We need to give the right decision tools with skin in the game.”

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