Price Transparency in Primary Care: Can Patients Learn About Costs When Scheduling an Appointment?

ABSTRACT:

Background

Cost-sharing in health insurance plans creates incentives for patients to shop for lower prices, but it is unknown what price information patients can obtain when scheduling office visits.

Objective

To determine whether new patients can obtain price information for a primary care visit and identify variation across insurance types, offices, and geographic areas.

Design

Simulated patient methodology in which trained interviewers posed as non-elderly adults seeking new patient primary care appointments. Caller insurance type (employer-sponsored insurance [ESI], Marketplace, or uninsured) and plan were experimentally manipulated. Callers who were offered a visit asked for price information. Unadjusted means and regression-adjusted differences by insurance, office types, and geography were calculated.

Participants

Calls to a representative sample of primary care offices in ten states in 2014: Arkansas, Georgia, Iowa, Illinois, Massachusetts, Montana, New Jersey, Oregon, Pennsylvania, and Texas (N?=?7865).

Main measures

Callers recorded whether they were able to obtain a price. If not, they recorded whether they were referred to other sources for price information.

Key results

Overall, 61.8% of callers with ESI were able to obtain a price, versus 89.2% of uninsured and 47.3% of Marketplace callers (P?ConclusionsPrice information is often unavailable for privately insured patients seeking primary care visits at the time a visit is scheduled.

SUBMITTER: Saloner B 

PROVIDER: S-EPMC5481227 | biostudies-literature | 2017 Jul

REPOSITORIES: biostudies-literature