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Aug. 8—An unusual approach to price transparency produced savings for both newly informed healthcare services shoppers and their uninformed fellow patients in the same markets, recent research found.
The insurer-initiated price transparency program sought to provide 61,000 patients with price and quality information on elective outpatient magnetic resonance imaging (MRI) providers in select market in 2010 and 2012.
But the price transparency initiative—an insurer study of which was published in Health Affairs—came with a twist. Instead of providing the price and quality comparison data on static websites, consumers received phone calls that highlighted the highest-value providers—taking into account both price and quality—in their area.
Consumers’ MRI provider selections resulted in a reduction in spending that averaged $99, or 9.4 percent, per test and a decrease in use of hospital-based facilities from 53 percent in 2010 to 45 percent in 2012. Price variation between hospital and nonhospital facilities for these patients dropped 30 percent, according to the study, which was funded and conducted by WellPoint.
A similar group of 44,000 patients who were not given the value comparison information and lived in different—but similar—communities instead saw price increases of $97, or 10.5 percent, which were in line with national medical inflation during the time period studied.
Hospitals that experienced less demand for MRIs over the course of the study reduced their unit MRI price from an average of $1,488 to $1,313. Meanwhile, nonhospital facilities appeared less demand sensitive, with the price for MRIs increasing in nonhospital facilities. The price increase in nonhospital facilities also occurred in the control group areas.
The benefits extended to non-participating patients living in the same markets as the intervention patients. The authors reported that more than 39,000 such MRI patients also had a reduction in their average cost per test, although not as large as participants’ reductions.
“These positive findings were attributed to responsiveness not only among members in the intervention group, but also among providers,” the authors wrote.
Further effects included average decreases of $99 for participating employer groups and $57 per test for non-participating employer groups in the same area. Employer groups in the reference area had a $97 cost increase per scan.
Other elective services that require preauthorization or pre-notification that could produce similar savings, according to the authors, include echocardiography or other high-tech imaging, such as positron emission tomography scans.
Keys to the unusual phone-based decision support included emphasizing quality along with price, according to the study authors.
The result “suggests that a price transparency initiative involving direct member outreach with integrated quality information can successfully reduce health care costs,” the authors wrote.
Publication Date: Friday, August 08, 2014
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Brian Grazzini, CFO, HealthPort, describes the importance of efficient and compliant information exchange and audit management in helping HIM staff spend less time on paperwork and more on mission-critical projects.
Cindy Matthews, executive vice president, Community Hospital Corporation, discusses how rural and community hospitals can use collaborative partnering to position for success through tough market conditions.
Rick Heise, senior vice president, revenue cycle, at Cerner Corporation, discusses the importance of integrating clinical and financial data to excel in health care’s changing payment environment.
Dale Hockel, senior vice president of operations, and Jim Fanelli, CFO, TriMedx, share strategies for elevating clinical engineering through innovative management programs.
Russ Graney, founder and CEO for Aidin, and John Laursen, head of business development for Aidin, share insights on how to improve care transitions between acute and post-acute care settings and incentivize high-quality patient outcomes.
Scott Elston, strategic accounts manager, GE Healthcare Services, describes how substantial cost reduction in health care requires rethinking business strategy and asset use.
Robert Williams, MD, director, Deloitte Consulting LLP, and Arielle Freiberger, product strategist, ConvergeHEALTH by Deloitte, explain how sophisticated retrospective, real-time, and predictive data analytics can inform decision making to reduce costs and improve care.
Stuart Hanson, director of business development (healthcare solutions) at Citi Retail Services, discusses how improving the payment experience can benefit consumers and healthcare providers.
Scott Schmidt, vice president, Cerner RevWorks, LLC, shares insights on best practices for maximizing a revenue cycle management partnership.
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