- Among patients who had a pre-planned visit to the hospital in the past year only 12% price shopped beforehand, and 97% of them were under the age of 65, according to a survey of 1,000 patients conducted by Waystar, a vendor of revenue-cycle management software. Just 28% discussed costs with hospital staff before the visit or got an out-of-pocket estimate.
- Among the 88% who did not price shop, 38% did not know prices varied, 24% thought pricing was too complicated to understand and 23% did not know how to comparison shop.
- Still, out-of-pocket costs were a financial burden to some survey respondents, particularly younger patients. While 65% never had to prioritize paying for healthcare over other expenses, 82% of those respondents were at least 65 years of age, and presumably enrolled in Medicare.
As Congress and the Trump administration push for price transparency, the survey suggests that consumers may not know how to comparison shop for healthcare services, evaluate different options based on price, or be aware that prices for healthcare services vary among different providers.
In a proposed rule released last month, CMS would require hospitals to disclose payer-specific negotiated rates with insurance companies in a consumer-friendly format, allowing comparisons among facilities.
Congress also is working on the issue. Sen. Lamar Alexander, R-Tenn., sponsored a draft bill that would also make public some information from negotiated rates, along with a ban of surprise medical bills.
However, costs certainly appear to matter to consumers, particularly as more of them are enrolled in high-deductible health plans.
In a recent survey of 1,743 adults from VisitPay, 66% cited cost as a factor they consider when choosing where to receive treatment. Cost tied with physician reputation, but it was less important than insurance (84%), reputation of the health system (75%) and location (69%).
The Waystar survey also suggests that consumers are not only price sensitive, but also concerned about paying for healthcare services. More than a quarter, or 26%, of survey respondents had to forgo a procedure or treatment because of the cost, including 76% between ages 18-39 and 24% between 40-64.
When it came to their most recent healthcare bill, only 15% of respondents who owe more than $500 have paid it in full. While 30% plan to pay the bill eventually, 19% do not plan to pay it at all, according to the Waystar survey.
Among the 35% polled who have prioritized healthcare bills over other expenses, 17% cited living costs, such as groceries or laundry; 15% cited rent or mortgage payments; and 12% cited paying off debt, such as student loans or credit card balances.
High-deductible health plans are increasingly common. As of 2017, 43% of adults with employer-based coverage were enrolled in such coverage, according to the Centers for Disease Control and Prevention.
But recent research suggests the plans have a significant downside. For example, a study from the Health Care Cost Institute showed that people enrolled in consumer-directed, high-deductible plans spend less on healthcare and use fewer services than their peers in other types of plans.