Price transparency leads to lower claims payments by patients and insurers

1. Individuals who searched for services using a price transparency service prior to receiving care had lower claims payments made by themselves and/or their insurer compared to those who did not utilize the price transparency service.

2. Claims payments for individuals who utilized the price transparency service were about 13% lower for laboratory and MRI or CT imaging tests and about 1% lower for office visits compared to those who did not use the price transparency service.

Evidence Rating Level: 2 (Good)

Study Rundown: With the increasingly cost-conscious nature of our current health care environment, there has been a growing push for increased transparency in health care pricing. This study is the first investigation to assess the relationship between searches made using a personalized price transparency service and subsequent claims payments made by patients and insurers. Study investigators focused on searches made for elective services including laboratory visits, MRI and CT imaging, and office visits and excluded those claims occurring in the inpatient or emergency department setting. Claims were included if they occurred within 14 days of the associated search. The study authors ultimately found that individuals who searched for services using a price transparency service prior to receiving care had lower claims payments made by themselves and/or their insurer.

Limitations of this study are largely due to its retrospective design, which did not allow researchers to determine patient motivation behind either choosing or not choosing to use the price transparency service or choosing or not choosing to ultimately receive care. Analysis was also limited to a small number of offered services. Thus, while this study appears to support the utility behind current efforts for increasing price transparency, further investigations are required to examine the effects of such information availability on health care spending and patient health outcomes as a whole.

Click to read the study, published today in JAMA

Click to read the accompanying editorial, published today in JAMA

Relevant Reading: Private insurers’ payments for routine physician office visits vary substantially across the United States

In-Depth [retrospective cohort]: This study included 502,949 individuals enrolled in insurance plans offered by 18 employers. Study individuals had access to a price transparency service that allowed individuals to search for specific services and in return, receive personalized price information based on their specific insurance plans. Study investigators focused on searches made for elective services including laboratory visits, MRI and CT imaging, and office visits and excluded those claims occurring in the inpatient or emergency department setting. Claims were included from if they occurred between 2010 and 2013 and within 14 days of the associated search, which occurred for 5.9% of laboratory tests claims, 6.9% of MRI/CT imaging claims, and 26.8% of office visits claims. Claims payments made by patients and/or their insurers were 13.93% (95%CI 10.28-17.43%) lower for laboratory tests, 13.15% (95%CI 9.49-16.66%) lower for MRI/CT imaging, and 1.02% (95%CI 0.57%-1.47%) lower for office visits for individuals who utilized the price transparency service prior to receiving care versus those who did not.

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