Online Advertising Increased New Hampshire Residents’ Use Of Provider Price Tool But Not Use Of Lower-Price Providers

Desai, Sunita; Shambhu, Sonali; Mehrotra, Ateev

doi:10.1377/hlthaff.2020.01039

Cited by 20 publications

(25 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is important to note that while federal legislation mandating hospital price transparency is in place, 31 existing evidence suggests that price transparency tools have had little effect on reducing patient out-of-pocket costs. 32,33 They are thus unlikely to be effectively utilized by patients without proper guidance from clinicians and case managers.…”

Section: Prognosismentioning

confidence: 99%

How Should Cost-Informed Goals of Care Decisions Be Facilitated at Life’s End?

Braun

Kakarala

et al. 2022

AMA Journal of Ethics

View full text Add to dashboard Cite

Interventions near patients' deaths in the United States are often expensive, burdensome, and inconsistent with patients' goals and preferences. For patients and their loved ones to make informed care decisions, physicians must share adequate information about prognoses, prospective benefits and harms of specific interventions, and costs. This commentary on a case discusses strategies for sharing such information and suggests that properly designed advance care planning incentives can help improve communication and decision sharing.Case DD is the designated durable power of attorney for health care, who has served well in this capacity by prioritizing her mother's previously expressed wishes to the best of her ability. DD has also, to this point, represented all DD's siblings as they discuss with care teams the care of their elderly parent in hospital and nearing death. DD and the health care team have discussed initiation of life-sustaining interventions (eg, mechanical ventilation, intubation, artificial nutrition and hydration), as well as a hospice care referral, given the patient's diagnosis and impending death.DD explains to the health care team that her mother had previously indicated she wanted all lifesaving therapies but that she values quality of life over extended life. The patient had also expressed a desire not to become a family burden. While sharing this sentiment, DD expresses, "For long hospital stays, no one needs to know the price of services to know it's expensive and that it will leave us bankrupt-$100 a day, $1000 a day out of our pockets. That is too much for most American families and it's too much for us. Our kids won't be able to go to college, and we won't have enough to pay for my father's medicines. CommentaryHealth care in the United States, especially near the end of life (EoL), is extremely expensive. Medicare is the primary payer for health services rendered to patients over age 65 in the United States, and an estimated one-quarter of total Medicare spending is on about 5% of Medicare beneficiaries in their last year of life. 1,2 These statistics are

show abstract

Section: Prognosismentioning

confidence: 99%

How Should Cost-Informed Goals of Care Decisions Be Facilitated at Life’s End?

Braun

Kakarala

et al. 2022

AMA Journal of Ethics

View full text Add to dashboard Cite

show abstract

“…20 To give patients access to information on provider prices, price transparency tools have been created, but use of these tools has been low and savings have been minimal. 3,7,8,[21][22][23] One explanation is that patients cannot act on the price information. For example, many services require physician referrals, which limit the agency of patients to price shop, even for "commodity" health care services.…”

Section: Introductionmentioning

confidence: 99%

“…Even if patients are aware of these programs, patients may not have information on provider prices and thus may not be able to navigate these programs 20 . To give patients access to information on provider prices, price transparency tools have been created, but use of these tools has been low and savings have been minimal 3,7,8,21–23 . One explanation is that patients cannot act on the price information.…”

Section: Introductionmentioning

confidence: 99%

Paying patients to use lower‐priced providers

Whaley

Sood

Chernew

et al. 2021

Health Services Research

Self Cite

View full text Add to dashboard Cite

Objective: Many employers have introduced rewards programs as a new benefit design in which employees are paid $25-$500 if they receive care from lower-priced providers. Our goal was to assess the impact of the rewards program on procedure prices and choice of provider and how these outcomes vary by length of exposure to the program and patient population.Study Setting: A total of 87 employers from across the nation with 563,000 employees and dependents who have introduced the rewards program in 2017 and 2018.Study Design: Difference-in-difference analysis comparing changes in average prices and market share of lower-priced providers among employers who introduced the reward program to those that did not. Data Collection Methods:We used claims data for 3.9 million enrollees of a large health plan.Principal Findings: Introduction of the program was associated with a 1.3% reduction in prices during the first year and a 3.7% reduction in the second year of access. Use of the program and price reductions are concentrated among magnetic resonance imaging (MRI) services, for which 30% of patients engaged with the program, 5.6% of patients received an incentive payment in the first year, and 7.8% received an incentive payment in the second year. MRI prices were 3.7% and 6.5% lower in the first and second years, respectively. We did not observe differential impacts related to enrollment in a consumer-directed health plan or the degree of market-level price variation.We also did not observe a change in utilization. Conclusions:The introduction of financial incentives to reward patients from receiving care from lower-priced providers is associated with modest price reductions, and savings are concentrated among MRI services.

show abstract

“… 3 , 4 , 5 , 6 Studies showed that use of these tools was associated with lower spending on imaging services but not on other services. 4 , 7 , 8 , 9 , 10 , 11 Nonetheless, price estimates for some medical services were queried more frequently than others. These so-called shoppable services tended to be routine, have higher out-of-pocket costs, and be nonemergent (eg, imaging services), allowing patients time to seek price information as they planned for care.…”

Section: Introductionmentioning

confidence: 99%

“… 3 It is also the most common reason for hospitalization in the United States. 11 , 12 Half of the 3.8 million deliveries each year are covered by private insurance (most others are covered by Medicaid), and 98% of those with private insurance have cost sharing for delivery. 13 , 14 In 2015, the mean out-of-pocket spending on maternity services among commercially insured individuals was $4500.…”

Section: Introductionmentioning

confidence: 99%