Over the years, we’ve written many times about the need for greater transparency in healthcare costs and improved access to data that would allow patients to be informed consumers of healthcare, able to choose providers and procedures based on price and quality outcomes. We know that even if price comparison data is available, it can still be difficult for the average person to really compare healthcare options. But in many cases, even the price comparison data isn’t available – and that seems like the most basic starting point for true transparency.
Some states have started creating report cards and websites that allow consumers to compare healthcare providers, and we know that high deductible, HSA-qualified (ie, “consumer directed”) health insurance policies are far more common than they were a decade ago. But consumers are still finding it difficult to truly comparison shop for their healthcare needs.
I believe this will change as time goes on. Healthcare costs continue to climb. There are plenty of efforts underway to stem that tide, but we’re still faced with annual health insurance premium increases in at least the high single digits (and health insurance premium hikes are a result of increased claims expenses – as the cost of healthcare continues to climb, so does the cost of health insurance). As long as health insurance premiums keep rising, individuals and businesses will keep looking for ways to make their coverage more affordable. In general, that means increasing the out-of-pocket exposure in exchange for lower premiums.
So while it might have been unusual ten years ago to have a policy with a deductible of $2000, it’s now quite common. Common too are HSA-qualified plans that require the insured to pay all expenses (doctor visits, prescriptions, etc.) until the deductible is met, as opposed to traditional policies that have copays for office visits and prescriptions.
This increased out-of-pocket exposure is likely to encourage more comparison shopping among patients, but it’s not the sort of thing that happens overnight. And it definitely requires a comprehensive database. Getting accurate information on your own by calling providers can be much more difficult than it sounds.
Happily, it looks like we’re going to be getting a good healthcare price comparison database here in Colorado, with the program launching this fall and comprehensive data available next year. This article from Kaiser Health News has all the details, and it looks promising. As the article states – and as we’ve noted here many times – healthcare costs sometimes seem to have little rhyme or reason. They can vary widely from one provider to another and from one area to another without much of a difference in quality of care or patient outcomes. But there are also some variables that have a justifiable impact on healthcare cost variation, such as the overhead expenses associated with teaching hospitals and hospitals that treat a higher-than-average number of uninsured patients. It sounds like the All Payor Claims Database is addressing those issues, so it will be interesting to see how the database accounts for them. I also like the fact that providers will be able to see how they compare with other providers before the data is released to the public, in order to allow the providers to start making improvements where necessary.
I can see this comparison tool – especially given how comprehensive it looks to be – being very beneficial for Colorado residents, and also helping to foster more competition among healthcare providers in the state.