Patients Want Healthcare Price Transparency, But Few Seek It Out [PODCAST]

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Welcome to the hospital finance podcast. You're go to source for information and insights. They can help you. Stay ahead of the challenges. Impacting healthcare finance and now the host of the hospital finance podcast. Michael passage is mike bass naughty and welcome back to the award. Winning hospital finance podcast improving healthcare price. Transparency has been the focus of many initiatives at both the state and federal levels of government. A recent survey conducted by the pioneer institute in massachusetts. Has shed some light on. How or if consumers actually take advantage of published pricing information to discuss the results of the survey. I'm joined by barbara anthony. Senior fellow in health care policy at the pioneer institute barbara. Welcome to the show. We'll thanks well. It's great to be on nyc definitely looking forward to this discussion. Barbara and for those In our audience who may not be familiar with the pioneer institute. Watch tell us a little bit about what you do. Their institute is first of all. We are a nonprofit. think tank. Where a bipartisan nonpartisan. Really and we're located in boston massachusetts. We we are we do research we And ice data we produce papers reports surveys And on a whole range of issues and what. Our work is really geared toward is trying to improve state government in many ways and also our economy in any way based on free market principles so areas that we work in and do a lot of publishing in education Better schools transportation transparency in government Government finances and healthcare. We do a lot of work at healthcare as well as we talked about before the show. our topic today around price. Transparency is something that is of the utmost importance to our hospitals right now and is certainly on the minds of our government officials for sure so With that let me ask you. Why did you initiate this particular study. And what were you looking at -chusetts now since twenty fourteen. We've had laws on our books that require price. Transparency from both providers meaning hospitals doctors clinics and insurance companies. So we have. We have a state law. Here that requires that providers give out prices upon request Of of a customer patient and insurance companies have to develop and they have developed what are called price transparency tool. So that if you're a member of an insurance company using go online and you can determine what the call you. The prices of various procedures among various providers and your out of pocket cost is Know what your remaining deductible is so we had these laws in massachusetts have been around now since twenty fourteen. I used to work for state government. I was under secretary of consumer affairs During the patrick ministration here. And so i was very involved in developing this law and then it's very initial implementation so the years go by and It's now What are we. We're in twenty twenty one so it's been quite a while Since the laws became effective in twenty fourteen and we we wanted to know wh what impact those laws have had and and whether consumers are taking advantage of them I'll tell you one thing we do know because we've done a lot of studies at pioneer on hospital and insurance company compliance with those and Unfortunately with respect to provider compliance particularly hospitals. We've found that Complaints hasn't been so great that That it's the costs. Pedals don't maintain a very friendly system for providing consumers with the price of medical procedure before you receive them companies do a better job of Of putting information out there Through their cost estimate or tools. As i mentioned the problem though is that the uptake by consumers by members of various insurance companies has been slow so we wanted to find out from the consumer viewpoint. Now we knew what was going on on the provider and the insurance company side. We're going to know what consumers thought about all this. So that's why we did this study. And who did you survey When you began to study well series done by a company called data research that da Dave logan who was a very well known pollster here in massachusetts but he doesn't national political polls what time he's the director of the suffolk university resource center so They conducted the poll for us. And we worked together on the questionnaire and analyzing the results. Very pleased with david zwicky. So he's an excellent pollster and that paul was to consumers across the state of massachusetts. We'll we'll did. Mike was this. You want one of the things that's really important to get too into the weeds on polling but In order for if you're gonna do upholds you're gonna do a survey it has to be statistically reliable invalid with that you look at that survey and you wanna say gee. I've got a lot of confidence that the results in the survey are accurate. And if i did a hundred more times it's gonna come out to be roughly the same. So that's another reason. Of course where we went to the professional pollster and what we did was David did developed a sample size of about a five hundred people. You gonna make a lot of this was done by telephone so landline and cell phone. No throughout the state of massachusetts all geographic areas across all income groups All kinds of other age groups but the main thing we wanted here was four five hundred people who got their health insurance through their employer or else they Bought it on the On the exchange. The massachusetts Ah the connector is what it's called so we did not want anyone who was receiving medicare. we didn't want anyone medicaid. We wanted people who were insured. By the private insurance companies here in the state and so we came the surveyors Came up with a five hundred people and that was the sample size and then List to questions we've asked us all surveys and That's basically Yeah how it was conducted and barbara. What did the survey results reveal about. How consumers access pricing information. Well unfortunately our survey results reveals some of what we already knew. That consumers do not access pricing information. Very much We we found out that only about one in five consumers in massachusetts Has ever tried to find the price of service in advance of getting that health. Care service And i'm assuming now that and we also found that the of those or five that comes from the insurance companies cost estimator till so. But that's a pretty low number of people who are trying who have thought about trying to find out the price of healthcare information And the the issue here is that you know. Most people just think that the information was available they didn't know it was available Hadn't thought about trying to access Pricing information didn't know where to go to find it so th that was We're totally surprised. But we were of course disappointed that so many consumers out there. Even though the information's available here Did not know that they could have access to it. And i guess on the flip side did anything about the finding surprise you re re taking back or anything you want me to rule out. There are a number of things that the surprise us. so we We did ask consumers. Well who would you trust to give you. who would you go to. Who would you trust and trust was the keyword there To get price information about healthcare from and surprise you know. Surprisingly i shouldn't say to surprisingly but insurance companies doctors were in the top tier In addition to that they commonwealth of massachusetts though. That's apprised us a little bit because you know a lot of people don't trust government but we have our we have a an agency here in massachusetts that does have a website where they do provide Some kind of price information about healthcare services for consumers so Doctors insurance companies and the stage where the most trusted entities here in massachusetts for consumers in terms of obtaining price information. That's what they felt. They could trust the most now the the thing. That was a little bit surprising. I think the hospital we're down at the bottom of the list is only like three or four percent of of the survey tokes surveyed. Said they would. They would trust hospital to go to in terms of obtaining price information. I think that is just a reflection of the fact that it's very hospital here. Don't make it easy for consumers to. I'm not suggesting that they make it easy elsewhere but here massachusetts our own. Pioneer studies have shown that it's very difficult for consumers to get price information from and it's also not something that's widely publicized. So i'm i'm not you know i'm not really surprised that that cape that that showed up so low on the on the scale in terms of trust and it just shows how much how much work there has to be done to bring that trust number up and provide consumers with that information. Well certainly hospitals will be I think motivated to move forward faster with price. Transparency efforts given the The push the federal government and the new rules true absolutely so it This this survey took place before the federal laws were were they. I think they are in the process of being promulgated and you had not taken effect yet so i think that the landscape has changed from from the results of this survey. But you know these but it was. It was It certainly needs changing and we can see that we've got We have a very low bar here that needs to be raised in terms of providing this information to consumers on you. You know it was interesting that we this idea of we as consumers you want. Would you like price information about a healthcare service before you obtain us and that was a very high number and trying to. I think it was almost like between seventy and eighty percent said. Yeah we do want to know the price of healthcare service before we get it but it but again people didn't know where to go did note was available. So there's a desire to know and i think that providers especially but it insurance companies to and employers also need. We all need to do a better job in terms of getting this information out to consumers. i mean some of the other things that consumers told us in the surveys. We you know we gave them some things to choose from there. They want easy access to price information. You know nobody wants to have to sit in front of a spreadsheet aunt and told through You know an excel to find out the price of service so they they would like apps on their phones. They would like Easy to read websites. That display of pocket costs They're also interested in you know incentives cash incentives to seek lower cost providers in a lot of people some. I shouldn't say a lot but some people in our survey thought they didn't matter which provider you went to with hospital where doctor that everybody charge the same price. Now that is you know at so not correct We have very wide variations in health. Care prices all around the country massachusetts. No different we have tremendous variation in healthcare prices. We have very expensive Hospitals and doctors and we have mid price. We have low priced so it is I wide range to choose from now. We're very interested in quality so we call these high value lower cost providers. But we're we're talking about here is trying to incentive consumers to Perhaps do some shopping around for those services healthcare services that are not an emergency services are Or you know very sophisticated. Tertiary our core care services but x-rays basic medical kinds of services. That everyone gets there is great. There's a great difference in price depending on where you go. And so What we found is that No matter what your income was people did want to know that this information and So and and they wanted easy ways of getting it. In addition to that people were Consumers i should say in this survey we're interested in getting cash back from near insurance companies if the consumer chose a a high value lower cost provider. So they're they're these there. Are these programs all over the country. They're not as widespread as we would. Halt we hope they would be But you can Earn money back And if you choose a provider that's less expensive than the the top tier providers for a particular procedure. The other thing that that we learned is that again people trust their insurance companies. Here and i know again that may go against the national grain but we do have very good insurance companies in massachusetts. They're always at the top of the. Us world news report List of Know good health plans and what what people and again they were. They were among the more trusted Entities that. Our consumers said they would go to for healthcare price information. So what consumers want it again. From our survey seventy percent of them wanted they were interested in getting notifications from insurance companies on ways in which they could save money the consumer could save money so they trust the insurance company to give them that information And interestingly enough they also wanna know how the price paid by the insurance company itself to the provider so about seventy five percent of the three out of four hundred or know that but well. I'm talking about insurance companies. I do want to say that one of the first questions. We asked consumers. Is you know how satisfied you know. Are you With respect to your insurance company and we this result was it was a little surprising to me. Because i'm not in the business of the insurance health insurance company business But seventy five percent of massachusetts consumers with commercial health. Insurance were very satisfied or satisfied with their current health insurance and We found out that that's consistent with. What the carriers but their own survey site that may not be true nationally. I think what. I just wanted to clear this up for your listeners to that ll why should that be in massachusetts. Isn't that our insurance companies. Don't make money. they do course but they they're. They're they're Organizational status is that of nonprofits. They do not have shareholders so and they are also very heavily regulated by the state so They do behave. i believe i. This is fair to say differently here. Massachusetts than many shirts companies in other parts of the country where they are for profit where they are four prophets where a state regulations lacks And so it kind of showed in our survey that people who were satisfied and also that they trust them to get this price information from great insights there barbara Based on what you've found what recommendations do you have for stakeholders around price transparency initiatives. Well this is something you know that. I've been saying for years here that and really we we need some be great to get some great leadership at the state level We bully pulpit here Certainly the state of massachusetts has A great interest as most states in lowering health care costs I mean we all do and one way to lower cost is of course to have to to make it easier for consumers to ago to high value lower cost providers but we need an educate. We need to educate people and that takes government leadership. It takes business leadership. I mean again. Employers have a great stake in this as well because many many large most all large employers self insured and they're paying directly for healthcare costs and small businesses are very concerned about their premiums. They wanna see healthcare cost we do so we get the insurance industry. We get government and we get the providers we absolutely need to have more buying from massachusetts hospitals and physicians and and And special you know. Special specialists across the board In terms of educating consumers and making it easier for consumers to get price transparency information. It can't just be one there really has to be a coordinated effort those those entities state government employers insurance industry and providers coming together to educate consumers. And we'd love to have an of course we have some good very very good Consp- healthcare consumer organisations here in massachusetts and wanted. You know they should be involved as well in terms of helping to spread the word that this information is available and that it can actually help save people money but direct people to situations where quality is high. Price is lower in effect. Actually we have. We're study started a few years ago here by our attorney general's office that the demonstrated what i said. That price is not an indication of quality in of healthcare and sometimes consumers have that misconception. You know we we call it. The neiman marcus effect. That that you think if it's a fancy place and are let's say higher priced institution that you're going to get better quality. That is not the case studies. Were done that. Show that price and quality the there was not a correlation that they were what statisticians call. It was a scatalogical Situation where they're not they're not correlated And so that's why it's even more important to get information out and that's why it takes say it takes a village but it takes government. It takes all those other stakeholders. I mentioned working together to provide the kind of education and access for consumers that they want borrow. Someone wanted to find out more about the survey. Where can they go. Well i think the easiest thing to do is to go to the pioneer institute website which is pioneer institute dot org and Follow the Health or care Tabs on that website and you can see the entire We've got about twenty over twenty Charts up and there's also Very recently An entire written. Report on everything. I've just talked about so The information out there very transparent people who see it and And and read it and And use it as they as a brand. You thank you so much for joining us today on. The hospital finance podcast. Thank you for inviting us and we appreciate it very much. This concludes today's episode of the hospital. Finance podcast for show notes and additional resources to help you protect and enhance revenue at your hospital. Visit bessler dot com forward slash podcasts. The hospital finance podcast is a production of bessler smart about revenue tenacious about results.

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