Patients don’t want to be bargain hunters

USC (US) — When it comes to health care, high deductibles aren’t enough to motivate patients to shop around for cheap medical services, a new study reports.

Consumer-directed health plans (CDHPs) offer low premiums but high deductibles on the premise that patients who are faced with deductibles of $1,000 or more for individual coverage (or twice that for family coverage) will look around for the best bargain.

In practice, however, that’s not the case.

Examining the consumer decisions with and without CDHPs when receiving nine common outpatient services (such as office visits, chest x-rays and colonoscopies) researchers found that patients with CDHPs paid roughly the same amount as their traditionally insured counterparts for 8 out of 9 services analyzed.


The only exception was office visits where patients with CDHPs paid about 2 percent less for office visits.

“We looked at data from 63 large employers and find little or no evidence that enrolling in a consumer directed health plan encourages price-shopping for health care” says lead author Neeraj Sood, associate professor at the University of Southern California.

The problem is twofold, Sood says. A lack of transparency about the costs of medical treatment makes it difficult to shop around for the best price—when is the last time you called around to radiology departments to inquire about the cost of an x-ray? Also, patients are most likely just to receive outpatient services from the providers their primary care physicians recommend.

“People don’t question their doctor’s advice,” says Sood, theorizing that one possible solution would be to find a way to incentivize those doctors to help their patients find the most affordable options possible.

Overall, CDHPs do seem to offer a cost savings to patients, but only because the high deductibles discourages patients from seeking care. That, in turn, can create health problems down the road.

Published in the journal Forum for Health Economics & Policy, the study is the latest in a series examining CDHPs, which have recently gained traction in the health insurance market. In 2006, CDHPs made up 4 percent of the total employer-provided health insurance plans in the US. By 2010—the latest date that statistics were available—that had jumped to 17 percent.

“CDHPs are gaining market share and the trend will likely continue,” Sood says. “We need more aggressive price and quality transparency initiatives coupled with high deductibles to increase consumerism in health care.”

Researchers from Carnegie Mellon University and the Rand Corporation contributed to the study, which was funded by the California HealthCare Foundation and National Institute for Aging.

Source: USC