Summary: Americans are hungry for health cost information, according to a new study by Public Agenda, funded by the Robert Wood Johnson Foundation. While this was not a total surprise to us, we are interested to see scholarly papers addressing the things people quite often tell us: “No one shops for health care” and “Most people believe that more expensive health care is better health care.” These things are not quite true, which we know (and if you’re reading this, you may know it too). Read on for details.
We’re deeply interested in this, particularly because it is so often an article of faith that no one shops and that patients (or consumers, or, as we like to call them, people) are dumb about the health care marketplace, blindly spending money and equating high prices with great care, among other things.
Here are some key findings from the study:
- 56 percent of Americans have tried to find information about health care prices before getting care, including 21 percent who have compared prices across multiple providers.
- Most Americans seem open to looking for better-value care. The majority of Americans do not believe that higher-priced care is necessarily better quality.
- Most Americans who have compared prices say they saved money.
- Looking for price information does not necessarily mean comparing prices.
- Most Americans remain unaware that prices can vary across health care providers.
- Latinos differ from Anglos (Latinos search more). Women differ from men (women search more). And lower-income people differ from upper-income (lower-income search more).
There’s also a link to these materials on the Public Agenda website. The survey results appear in the Public Agenda report, “How Much Will It Cost?” The data are based on a nationally representative survey of 2,010 adults conducted between July 29 and August 31, 2014, via telephone and Internet in 50 states and the District of Columbia. The project was funded by a grant to Public Agenda from the Robert Wood Johnson Foundation.
The study comes at an interesting time for me. I testified recently at the California State Senate’s Health Committee hearings on rising costs. After I got done explaining how people are shopping for health care, the following witness — Neeraj Sood, a University of Southern California economist — told the committee that people aren’t shopping for health care, and that they equate high prices with better care, among other things.
Disclosure: when the Public Agenda study was in its formative stages, the lead author, David Schleifer, a senior research associate at Public Agenda, reached out to me as an expert in the field. We had a conference-call conversation in January 2014. I told him that people are shopping for health care. He and his colleagues on the call expressed some surprise, according to my notes. So I was interested to see that the results bore out what I had told them.
Were the authors surprised? Yes, the results were unexpected.
Schleifer presented the results at a Data and Society event in Manhattan recently. After the presentation, I asked him some questions by email.
Q. Were you surprised at the results?
A. “Somewhat. We didn’t expect to find that so many people were seeking price information. We didn’t think that no one was doing it, but based on all of the background research we did, we expected it to be pretty uncommon.
“Of course, you told us otherwise. When the survey had been piloted on about 100 people and the rate of price information-seeking was already around 50 percent, we actually made a dozen or so phone calls ourselves to follow up with survey respondents and hear their stories, which helped us feel pretty confident in the reliability of the results we were getting.
“After the survey, we also did follow-up interviews with even more price information-seekers from the survey, to get more details about how and why they sought price information.
“As you know, finding price information can still be difficult for many people, which is why we asked people whether they had ever tried to find health care price information. Separately, we also asked people whether they actually found the information they were looking for and how they used it.”
Q: Anything else you’d like to say?
A. “It is difficult for us to say how often people are seeking price information.
“We actually asked a question about the frequency with which people have sought price information and couldn’t decide how to interpret the results: 57 percent of price information-seekers say they have done so once or twice, 24 percent of price information-seekers have done so three to five times, and 14 percent of price information-seekers have done so more than five times.
“But we can’t say how often people have sought price information relative to how often they could have sought it.
“Are most people looking for price information only once or twice because they don’t go to the doctor very often? Are people looking for price information every time they need care or only sometimes? Only the first time they visit a new provider or every time their insurance plan changes?
“These are questions that our survey can’t answer but that we’d love to figure out how to address.”