Few Use Quality, Price Information for Health Decisions

Many overconfident about their ability to pay medical bills without financial strain

By Jordan Rau © Kaiser Health News Apr 27, 2015
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Despite the government’s push to make health information more available, few people use concrete information about doctors or hospitals to obtain better care at lower prices, according new a poll from the Kaiser Family Foundation.

Prices for the health care industry have historically been concealed and convoluted, unlike those for most other businesses. The Affordable Care Act aimed to make such information more transparent. People shopping for insurance can now compare the prices of competing plans through online marketplaces, including premiums, deductibles and their share of any medical expenses. The federal government also publishes more than 100 quality ratings about hospitals, as do some large private insurers. Private groups such as Consumer Reports and U.S. News & World Report also rate providers, and Internet forums such as Yelp are now littered with easily accessible opinions.

Yet the Kaiser Family Foundation poll found that about two of three people say it is still difficult to know how much specific doctors or hospitals charge for medical treatments or procedures. Only about one in five people said they had seen specific cost or quality information about a hospital, insurer or doctor.

The poll found that this information rarely makes a difference. About 6 percent of people ever used quality information in making a decision regarding an insurer, hospital or doctor. And fewer than 9 percent used information about prices, most commonly in relation to health plans. Only 3 percent said they used price information about physicians, the poll found.

This lack of practical information may be related to another major finding from the poll: people are overconfident about their ability to pay medical bills without financial strain.

A majority of people told pollsters they had enough insurance coverage or money to pay for their usual medical costs or for an unplanned hospitalization. A majority also said paying insurance premiums, deductibles and their share of medical costs was relatively easy.

However, when asked how they would handle an unanticipated $500 medical bill, only 47 percent of insured adults under 65 said they would pay the bill in full immediately. The others said they would put it on a credit card and pay it out over time, borrow money or not be able to pay the bill at all. Not surprisingly, those bills would be a bigger problem for those who lacked insurance.

If the medical bill were $1,500—a sum that is less than the deductible in many insurance plans—25 percent of people with insurance thought they could pay it off immediately. Another 29 percent said they would add it to their credit card debt, and 25 percent said they could not pay it at all.

The poll was conducted April 8-14 among 1,506 U.S. adults.

Jordan Rau is a staff writer for Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente. © 2015 Kaiser Health News. All rights reserved. Republished with permission.

Hospital Rankings: Another Viewpoint

An April 2015 commentary by the Chelko Consulting Group contends:

[I]t would be easy to think that the evaluation and subsequent ranking of hospital services is a good thing. After all, hospitals are where really important things happen to our bodies. So, we naturally want to know which hospitals are most likely to provide the level of treatment that produces the desired results, and maybe even more importantly, which are less likely. Benefits managers want to know as well, so they can encourage their plan members to use high quality hospitals on the notion that higher quality ultimately means lower cost. So, these hospital rankings are a big win, right?

Unhappily, the utility of the major hospital ranking services isn’t even as high as the collective views of coaches and sports writers. Intentions are in the right place, but like the coaches and sports writers the hospital rating systems focus on different performance attributes— and weigh them differently.

The commentary cites a March 2015 article in the journal Health Affairs, “National Hospital Ratings Systems Share Few Common Scores and May Generate Confusion Instead of Clarity,” which concluded: “The complexity and opacity of the ratings is likely to cause confusion instead of driving patients and purchasers to higher-quality, safer care.”

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