Historically, the U.S. health care system has not made it easy for people to find out how much their care will cost them out of pocket. Public Agenda, with support from the Robert Wood Johnson Foundation and the New York State Health Foundation, recently conducted a survey to explore how Americans are trying to find and use this information.
The survey’s key findings include:
- 50% of Americans have tried to find out, before getting care, how much they would have to pay out of pocket, not including copays, and/or how much their insurers would pay.
- 20% of Americans have tried to compare prices across multiple providers before getting care.
- About one in three Americans—28%—has tried to find out a single provider’s prices rather than comparing.
- Most Americans understand that health care price and quality are not associated. Seventy percent of respondents said, for example, that higher prices are not typically a sign of better medical care.
- 59% of Americans who have tried to compare prices said they chose a less expensive doctor, hospital, medical test, or treatment.
- Among people who had never tried to find price information before obtaining medical care, 40% indicated they would be inclined to choose less expensive doctors if they knew the prices in advance. However, 43% would not be inclined to do so, and 17% didn’t know.
- Only 17% of residents of states with state-administered price information websites indicated that they have heard of the names of their states’ websites. A smaller percentage—7%—of people in those states who have tried to find price information said they have used their states’ websites.
- More than half—56%—of Americans either believed doctors charge basically the same prices for the same services (37%) or said they didn’t know (19%). Similarly, 55% either believed hospitals charge basically the same prices for the same services (32%) or said they didn’t know (23%).
- 57% of Americans who have not tried to find price information before getting care indicated that they would like to know the prices of medical services in advance. However, 51% of them indicated they were not sure how to do so.
- 63% said there is not enough information about how much medical services cost; 23% said there is enough information; and nearly 13% didn’t know.
- 70% of respondents thought it was a good idea for doctors and their staffs to discuss prices with patients before ordering or doing tests or procedures or referring them to specialists. However, only 28% said doctors or their staff have brought up prices in conversations with them.
- 80% of respondents thought it was important for their state governments to provide people with information that allows them to compare prices before getting care.
Based on these findings, Public Agenda outlined the following implications and questions for policymakers, insurers, employers, and providers, as well as for-profit and nonprofit price information providers, to consider.
- Help people compare prices to help them save money.
- Direct price transparency efforts toward people who face high out-of-pocket costs and toward those whose insurance coverage is unstable.
- Recognize the diversity of sources people use to try to find price information.
- Equip medical professionals and their staffs to discuss prices with patients or to refer patients to reliable sources of price information.
- Employers should find ways to build trust with more of their employees.
- States should consider a range of ways to make price information more transparent.
- Support further exploration of variations among states in how people find and use price information.
The findings came from a nationally representative poll of 2,062 U.S. adults 18 years of age and older and representative surveys of 808 adults in Texas, 802 adults in New York State, 819 adults in Florida, and 826 adults in New Hampshire. The interviews were conducted from July through September 2016. Data for both surveys were collected through 60% online surveys and 40% phone interviews, including cell phones.
Source: Public Agenda; April 6, 2017.