Paying patients to shop yields modest savings, Health Affairs study finds

By | March 6, 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.

Filed Under: Payer

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