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Do patients choose lower-priced facilities after checking procedure prices?

The JAMA Network Journals

If patients know beforehand how much a procedure will cost do they pick a lower-priced facility?

Price information in combination with insurance benefits designed to share cost savings when patients choose low-cost health care facilities has been associated with lower spending. But the impact of price information on patient choices when they have commercial insurance without those incentives is largely unknown.

The study by Anna D. Sinaiko, Ph.D., M.P.P., of the Harvard T.H. Chan School of Public Health, Boston, and coauthors examined Aetna's web-based price tool on choice of health care facility for eight services.

The tool is offered to 94 percent of commercial enrollees and, of them, 3.5 percent used the tool and constituted the study sample. Services included in the study were carpal tunnel release, cataract removal, colonoscopy, echocardiogram, mammogram, several magnetic resonance imaging and computed tomographic imaging services, sleep studies and upper endoscopy from 2010 through 2012 (N=181,563).

The authors compared whether patients who looked at price estimates for their specific procedure were more likely to choose lower-priced health care facilities than those who used the tool to investigate other procedures or had their procedures before the tool was widely available.

Male patients more frequently used the tool to look at price estimates before a procedure. Patients who looked at price estimates before a procedure were more likely to pick health care facilities with lower relative price estimates than other patients for imaging services and sleep studies.

Searching for price information also was associated with a lower adjusted total spending of $131 for imaging and $103 for sleep studies, according to the article.

The authors note the study included only one insurance carrier and data for only the first two years the price transparency tool was available.

"Future research is needed to determine whether these patterns hold if and when these tools are used more broadly," the research letter concludes.

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(JAMA Intern Med. Published online October 24, 2016. doi:10.1001/jamainternmed.2016.6622. Available pre-embargo to the media at http://media.jamanetwork.com.)

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