Patients want price transparency in healthcare, but don’t really shop around

Pricing transparency is key for patients to have a positive billing experience with their healthcare provider, according to a new survey, but patients aren’t always asking for price estimates or taking the time to shop around for lower-cost services.

Just 28% of adults talked with hospital staff in advance or received an out-of-pocket expense estimate for their care, according to the survey, which was conducted by Waystar and queried 1,000 consumers about their last hospital encounter.

Insured patients who had a negative experience during their last trip to the hospital cited a lack of pricing transparency as the top cause. Another 23% cited insurance coverage, while 14% said their experience was tainted by complex medical bills.

As healthcare costs have rapidly risen over the last several years, the Trump administration recently required hospitals to post the list prices of services online. However, these lists may not be all that helpful to the everyday consumer. HHS also recently proposed requiring the publication of negotiated rates for services between insurers and healthcare providers, potentially providing more information for consumers to price-shop for planned services.

However, only 12% of survey respondents said they price-shopped in advance of a planned or routine visit. Of this group, 97% were younger than 65. For the other 88% of consumers who didn’t price-shop, 38% didn’t know prices varied; 24% said it was too complicated; and 23% said they didn’t know how to comparison shop.

The low rate of price-shoppers is critical, as more than 25% of respondents said they’ve forgone a procedure or treatment due to cost.

Once consumers had their final bills, 21% said they talked to or planned to talk to the hospital to discuss it. Younger patients were more than two times as likely to call the hospital to discuss their bill compared to baby boomers (19% to 37%, respectively).

This could be because medical bills are more burdensome for younger generations, and older patients tend to have the smallest bills. Still, only about one-third of respondents overall compared their explanation of benefits from their insurance coverage to their hospital bill.

Hospitals, while grappling with new policies about posting prices, also should consider patient preferences with billing. In particular, 37% prefer to pay their bill online, while only 6% prefer over the phone. Nearly 30% each like to pay in-person or in-office and through physical mail. Hospitals could also take a more tailored approach to ensure patients understand their bills and improve their billing literacy, the report concludes.