States struggle to get consumers interested in healthcare cost sites
When Oregon mandated in 2009 that claims data from all payers in the state be made public, the hope was it would help slow spending and improve quality of care.
Advocates of the legislation figured providers would have a reason to keep prices low as consumers sought out cheaper options when they shopped for care.
The problem was that even though the information was available, people didn’t seek it out. Claims data is complicated for the average person to digest and understand. Most people also didn’t know the information was there in the first place.
So the Oregon Association of Hospitals and Health Systems in 2015 launched the Oregon Hospital Guide, a website intended for residents to get easier access to claims data in a user-friendly format. “We thought there was a real opportunity here to promote transparency,” said Andy Van Pelt, executive vice president of the association.
But attracting consumers to a website they don’t know exists hasn’t been without challenges. The association has tried to increase awareness of the site through search engine optimization, and has worked to make the site easier to navigate. “We’re investing in this because it’s the right thing to do, but the people we are targeting aren’t using it,” Van Pelt said.
Oregon isn’t alone. Other states have tried to encourage healthcare shopping through price websites and faced hurdles. Not only must the sites be easy to use, but publicizing them takes a great deal of effort.
Organizations “do a terrible job of making people aware this information is available,” said Francois de Brantes, vice president and director of the Center for Payment Innovation at the not-for-profit Altarum Institute. “In healthcare, when something is built for consumers, there is no effort to let them know it’s there or how to use it.”
In their most recent report card on state transparency efforts, Catalyst for Payment Reform and the Health Care Incentives Improvement Institute gave D or F grades to 13 states that had mandated all-payers claims databases but hadn’t made any effort to gather the information or make it easily available.
A well-designed site is important, because patients generally still don’t think to shop, de Brantes said.
New Hampshire’s approach
Given that attitude by consumers, New Hampshire spends a lot of time trying to increase awareness and encourage more use of its NH Health Cost site.
Launched in 2007 by the New Hampshire Insurance Department, the site offers information on prices and quality of care given at hospitals across the state. Despite the host of information available, a 2014 study found that less than 1% of the population used the site.
To increase clicks to the site, the state redesigned it in March 2016 to be more user-friendly. The site now includes cost information on more than 115 common medical procedures and quality of care data from the CMS. Users can look up costs by procedure or by ZIP code. A national average for each quality measure is displayed as well.
Costs for procedures at hospitals can also be estimated based on a consumer’s insurance. And a new tab was added to the website to give people a better understanding of how reimbursement works. “We tried to make it as easy as possible for consumers to navigate,” said Maureen Mustard, director of healthcare analytics at the New Hampshire Insurance Department.
Outreach efforts also intensified. Staff members visit providers, medical management groups, billing specialists and human resource departments at employers to let them know about the site.
Since the site relaunch, the state has reached out personally to about 500 stakeholders, said Eireann Aspell, outreach coordinator at the New Hampshire Insurance Department. In the last quarter, the site had nearly 15,000 views, up from just 18,000 visits for all of 2015.
Whether or not the site has influenced consumer choices or helped them achieve lower healthcare costs is hard to gauge. “It’s a difficult analysis to do,” said Tyler Brannen, health policy analyst at the department.
Brannen said he has noticed a heightened consciousness among providers to keep prices competitive because they are public. “We’ve seen providers respond. They don’t want to have prices out of line.”