As a recent U.S. executive order made clear, healthcare price transparency is on the horizon. Patients can look forward to a more straightforward financial experience as consumer price and quality transparency tools become more commonplace.
For decades, consumers have been unable to shop for healthcare the way they shop for other goods and services—and both providers and patients have suffered the consequences. According to Gallup’s annual Health and Healthcare poll, 26% of U.S. patients delayed healthcare in 2018 because of cost concerns, and 41% skipped needed emergency care.
The Connection Between Volume and Transparency
Can adopting price transparency also benefit providers? Perhaps surprisingly, the research indicates yes. Several studies conclude that increased price transparency boosts patient satisfaction, volume, and revenue. In one small study led by Johns Hopkins researchers, five out of six ambulatory surgery centers reported a median patient volume increase of 50% one year after implementing price transparency.
As healthcare providers scramble to comply with emerging regulations, it’s important to keep in mind that many existing cost estimator and price transparency tools—in their current state—are not effective. Patients are unlikely to navigate hospitals’ published list prices, as these figures do not represent their likely out-of-pocket fees. To be effective, price transparency data must be member-specific, reflecting not only a specific insurer’s contracted rates but also the patient’s benefits and claims data—in addition to corresponding quality data.
The Rise of Shoppable Healthcare
The good news is that healthcare consumers are primed and ready to shop. In fact, 51% of millennials report shopping online for medical services, an increase of six percentage points from the previous year in UnitedHealthcare’s annual survey.
To offer the greatest benefit to patients, many industry leaders recommend that providers’ transparency efforts focus on “medical products and services that are truly shoppable, such as some prescription drugs or diagnostic imaging,” as well as dental and vision services.
In the race to develop effective price transparency tools, perhaps the easiest place to start is with the healthcare consumer’s financial experience. Change Healthcare conducted a three-year research study to better understand consumer pain points from the initial search for care to the billing and payment process.
Our white paper, “Healthcare Consumer Insights: Financial Care,” illustrates the confusion and lack of empathy patients face as they attempt to navigate their financial experience. It’s clear that healthcare consumers need guidance in understanding what care will cost before they receive that care.
Providing patients with the ability to shop and effectively budget for healthcare can transform the entire industry. By centralizing insurer data and integrating quality ratings, reviews, and member-specific pricing, providers can help each consumer know what a specific procedure will cost them under their health plan.
1. West Health and Gallup, “The U.S. Healthcare Cost Crisis,” 2019. https://news.gallup.com/poll/248081/westhealth-gallup-us-healthcare-cost-crisis.aspx#ite-248093
2. Alexandra Wilson Pecci, “Publish Your Prices, Boost Your Bottom Line,” HealthLeaders Media, July 2, 2018. https://www.healthleadersmedia.com/finance/publish-your-prices-boost-your-bottom-line
3. UnitedHealthcare, “Consumer Sentiment Survey,” September 20, 2018. https://newsroom.uhc.com/consumer-sentiment-survey-2018.html
4. Lovisa Gustafsson, “Hospital Price Transparency: Making it Useful for Patients,” The Commonwealth Fund. February 12, 2019. https://www.commonwealthfund.org/blog/2019/hospital-price-transparency-making-it-useful-patients