Price Transparency Tools Remain Key for Financial Experience

It’s going to take more than the federal healthcare price transparency tool to revamp the patient financial experience, as patients continue to avoid care because of healthcare affordability concerns, according to Ribnik research commissioned by HealthSparq.

Overall, 44 percent of healthcare consumers avoided healthcare access because they were uncertain of the total cost or patient financial responsibility. This is up from last year when a quarter of patients reported avoiding care due to uncertain healthcare costs.

These findings come as health payers prepare for a CMS price transparency rule. Starting in July 2022, health payers will be required to publicly post pricing information for covered items and services, according to the agency.

This payer price transparency rule is a complement to the hospital price transparency rule, which went into effect in 2021 but still sees scant compliance.

It’s going to take more than the CMS regulations to bring price transparency to the patient financial experience, the HealthSparq report showed. Nearly two-thirds of the about 1,000 survey respondents said they were not aware of the CMS price transparency rules or that their insurance providers will be required to offer price transparency to members.

Once explained to them, 81 percent of respondents said they favor these kinds of rules.

That all said, things are looking up, the survey added. Seventy percent of respondents said their insurance provider now offers a healthcare price transparency tool, the biggest-ever proportion of patients saying such. In 2019, only 45 percent of patients could say their insurance plans had a healthcare price transparency tool.

And these technologies are helping to ease the patient financial experience, the respondents furthered. Of those with access to a price transparency tool, 67 percent said they have actually used it; most of those who haven’t used it said they have not had a healthcare need or occasion to use the tool.

Having a reliable price transparency tool will be key for payers, the survey showed. Three-quarters of patient respondents said they trust their payers for accurate price estimates, but if those estimates are inaccurate, payers stand to lose credibility with their consumer bases.

Nearly 90 percent of patients said they want accurate information about their financial responsibility before accessing care, the survey added, while 76 percent said they wish they had more control over how much they pay for healthcare.

These tools are offering more than just price estimates; patients laud payer price transparency tools for helping them to find providers who are in their insurance network (72 percent), access telehealth (55 percent), and select a primary care provider online (53 percent).

Far fewer patients are using this tool to select the lowest-cost provider, the survey added. Rather, payer price transparency tools should consider the key factors patients account for when selecting a provider: being in-network, distance from home, years of experience, appointment available, and then cost.

Payers may also include patient satisfaction reviews, clinical quality outcomes data, availability of telehealth, and provider approaches to patient care of philosophy to provider profiles, the survey indicated.

As payer organizations work to support healthcare price transparency, the survey suggested they consider digital means. Patients largely prefer digital communication, with 66 percent say they prefer email communication from their payers and providers. Alerting patients to the availability of a price transparency tool via email may help spur patient use.

These tools should also be clear and easy to use. Forty-eight percent of respondents said they need price transparency tools to make it easier to find information, while another 46 percent want more say in how their payer communicates with them, the survey concluded.