Will People Comparison-Shop for Health Care?

If patients know how much their medical care costs, they’ll shop around for the cheapest option — and over time, health care costs will go down. At least, that’s the idea behind the drive to improve price transparency, a strategy embraced by Donald Trump, among others.

But a recent study suggests it’s not so easy to get people to shop. Sunita Desai, a fellow in health care policy at Harvard Medical School, and her co-authors looked at two companies that introduced an online tool that lets employees compare prices for things like lab tests and outpatient surgeries. After a year, only 10 percent of employees had used the tool. And those who had access to it actually had higher out-of-pocket spending on average than comparable employees at other companies who didn’t have the tool.

Since many people don’t think about their health care often, said Dr. Desai, participants may have simply forgotten to use the tool. Even if they remembered to do so, they may have had little incentive to go with the cheapest option — many of the medical services they searched for cost more than their deductibles, which means they would pay the same amount no matter which provider they chose.  Raising deductibles might not help either; previous research has shown that when deductibles get higher, patients tend to go to the doctor less frequently, which could be hazardous for those with chronic illnesses.

Other factors also might make patients less inclined to price shop. Many people get referrals from their doctors and may be uncomfortable seeing a different provider instead, said Ateev Mehrotra, one of the study’s co-authors. And Dr. Desai said patients’ relationships with their doctors, recommendations they get from friends, and their perception of the quality of care they’ll receive may all matter more to them than price.

The study’s authors believe people might be more inclined to make price comparisons if they were prompted to do so when they were about to make a health care decision, or if their health plans provided a clear incentive (like a monetary bonus) for choosing a cheaper provider. Basically, the research suggests that giving consumers more information on prices won’t necessarily have a big impact on health care spending.

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