March 5, 2019
Dive
Brief:
- Paying
patients to shift to lower-price providers could be a successful — albeit
limited — option for helping employers and insurers lower healthcare
costs, a new study in
Health Affairs suggests.
- Researchers
looked at the impact of a program that rewards people who agreed to
receive one of 131 elective procedures from a designated lower-price
provider. The checks ranged from $25 to $500, depending on the price and
service.
- Over 12 months, prices paid for
the targeted services dipped 2.1%, leading to $2.3 million in savings, or
about $8 per person. The biggest effects were seen in MRI and ultrasounds,
with no noticeable price drop in surgical procedures.
Dive
Insight:
Reward
programs could prompt more people to think about shopping for healthcare, which
is in line with price compare apps and
a push for more transparency on
hospital prices from CMS.
And
patients appear to be fed up with rising costs, too. A recent VisitPay report found
cost matters just as much as a physician's reputation when choosing where to
get medical care. Nearly two-thirds of U.S. adults said cost was a major
influence in assessing overall satisfaction with a doctor or health system, and
more than four in 10 said rising costs would strongly influence their decision
or ability to seek care.
The
employers in this study all participated in Health Care Service Corporation's
Member Rewards program, which launched in 2017. The results may not seem
substantial, but the study was small, of 29 employers with 269,875 eligible
employees and dependents.
Price
reductions were mostly seen in imaging services. During the first 12 months of
the program, MRI prices fell by 4.7%, ultrasound by 2.5%, mammograms by 1.7%
and CT scans by 1.4%.
And
despite limited use of the program, results suggest patients who shopped for
lower-cost care saved money, to the tune of 78% for ultrasounds, 33% for
mammograms and 25% for MRIs.
The
researchers also found a 0.3% relative reduction in utilization among patients
who received rewarded services.
"This
reduction in utilization may be due to patients' using the price shopping
tools, becoming more aware of these out-of-pocket liabilities, and deciding to
not get care from any providers," the researchers wrote. "Whether
this reduction in care is beneficial or harmful depends on the relative impact
on low- or high-value care."
Still,
despite modest savings, it is unlikely patient-centric models will be as
effective in curbing costs as ones that directly affect payers and providers,
the researchers said. They note that while employers prefer rewards, which
appeal to employees, reference pricing programs achieve considerably more cost
savings — 15% versus the 2.1% savings in the member rewards program.
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