Patients Find it Hard to Price Shop for Health Care - New Research Insights

Can we trim health care spending by counting on patients to shop for value when they decide where to receive medical care?

A new study by NIHCM research grantee, Zack Cooper, PhD, of Yale University and colleagues examining where patients choose to receive elective, lower-limb MRIs suggests that patients are not likely to choose lower priced providers. The quality of MRIs is not highly variable across providers but prices do vary widely, providing patients with the opportunity to shop based on price as they schedule their non-emergency care. Yet study patients struggled to price shop for this basic service. The study found:

• Patients opted to use more expensive MRI providers even when lower-priced imaging centers were available closer to home, incurring higher out-of-pocket and insurer costs than necessary.
• Very few patients used an available price transparency tool to compute their expected out-of-pocket costs for different providers, despite facing high cost sharing for the service.
• Patients’ referring physicians were the key determinant of where the MRI was received, and they tended to send their patients to a small set of ‘usual providers’ regardless of price.

Study results suggest that giving referring physicians more information about costs and incentives to help patients select better value providers is likely to be more productive than simply relying on patients, on their own, to shop for value.

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