Face-to-Face Price Transparency

David Schleifer is a senior research associate at Public Agenda, a nonprofit organization that helps leaders and communities navigate complex issues through nonpartisan research and engagement. David conducts public opinion and stakeholder research through surveys, focus groups, and in-depth interviews on topics including healthcare, K-12 education, higher education, and participatory budgeting. David holds a Bachelor’s degree in sociology from Wesleyan University and a PhD in sociology from New York University. You can follow him on Twitter @david_schleifer
When people seek price information before getting care, they are not just looking for data online-they are turning to providers and staff for face-to-face help.
Co-written by Andrea Ducas, MPH, a program officer with the Robert Wood Johnson Foundation
 
Efforts to inject greater price transparency into healthcare continue to gain momentum. Just this year, Blue Cross and Blue Shield of North Carolina published its public online cost estimator for services and procedures in the state. A month later, the Health Care Cost Institute introduced Guroo, a tool to that provides users with national price averages for several bundles of healthcare services.

These efforts join those of many other companies including Castlight and Healthcare Bluebook, which continue to develop the price information tools they offer to the public and to employees of some private companies. Meanwhile, the nonprofit Clear Health Costs crowdsources price information from patients and physicians.
 
While insurers and private companies have tended to lead these efforts, what role can practice and hospital administrators play in increasing price transparency? Public Agenda, with support from the Robert Wood Johnson Foundation, recently conducted a national survey to explore the knowledge, behaviors and attitudes of consumers regarding price information in healthcare. The findings suggest that practice and hospital administrators can make active, positive contributions to price transparency.
 
According to the survey, 56% of American adults have at least tried to find out their out-of-pocket costs (not including a co-pay) before getting care, or have tried to find out how much their insurance would pay a doctor or hospital. Markedly, the survey also found that while people do use their insurers’ websites and call their insurers to find price information, third-party sites are not the most common sources consumers are using to find healthcare price information.   
 
Instead, people report that they more frequently seek price information through conversations with receptionists and other office staff and with doctors. The survey found that 48% of people who had sought price information before getting care had asked a receptionist or other office staff about prices.  And 46% of people who had sought price information before getting care had asked a doctor about prices. In other words, when people are seeking price information, they are not just looking for data online—they are turning to providers and staff for face-to-face help.
 
For practice and hospital administrators, equipping receptionists, nurses and doctors with price information tools and training in how to use them may be an important step toward helping patients and families navigate and understand their care. In order to play this role, these professionals need to be able to access up-to-date price information for entire episodes of care that are specific to insured people’s benefits and that reflect any discounts available for uninsured people. Additionally, they’ll need the skills and support to be able to discuss prices in ways that are productive and supportive across patient populations, particularly for people with complex, chronic conditions or those who are low-income.  
 
While doctor-patient conversations about costs are not necessarily easy, organizations such as Costs of Care are working on helping physicians understand how to discuss costs with their patients. Just this month, the American Medical Association announced a policy encouraging physicians to talk with their patients about the cost and price of services at the point of care. Some researchers are also now studying the frequency with which doctors and patients discuss costs and the impacts that those conversations have on care. Others are investigating the impact of price information on physicians’ test ordering rates, care quality, decision making, and conversations with patients.
 
Doctor-patient interaction about prices and costs is an area ripe for better and more actionable information. The roles of receptionists and nurses in helping patients understand prices and costs also merits further inquiry and experimentation.  While reliable data is important, patients still need face-to-face help understanding and using price information, so that they can get the care they need without incurring financial harm.
 


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