Making people pay more of their health care bill out of pocket does not make them smarter shoppers, according to a new study published in Health Affairs, which corroborates earlier research.
The big picture: Part of the idea behind those ever-increasing insurance deductibles is that patients who have to put more of their own money on the line will become better consumers, comparison-shopping for the highest-quality, lowest-cost services.
- But it doesn’t seem to work that way in the real world.
What they’re saying: In the Health Affairs survey of people with high-deductible plans …
- Just 25% had talked to their provider about how much something would cost.
- 14% had compared prices at multiple facilities.
- 14% had compared quality metrics for multiple facilities.
- 7% had tried to negotiate a price.
Between the lines: People don’t do these things because they don’t even think of it, or assume it won’t work. Or, to borrow some truly glorious academic-speak: “Perceptions of futility were common impediments to engagement.”
- A separate study, also published in Health Affairs, did find one effect of high deductibles: They seem to make women more likely to delay treatment for breast cancer.
Yes, but: There’s some evidence that if patients try to avail themselves of comparison-shopping tools, they can achieve real savings, at least for MRIs and other imaging procedures.