Transparent savings: Imaging claims payments drop with use of price transparency platform

Research suggests patients might be thriftier shoppers if given the right tools. When a group of patients used a price transparency platform, it resulted in lowering claims payments for advanced imaging services by more than 13 percent, according to a study published in the Oct. 22/29 issue of JAMA.

“Patient access to pricing information before obtaining clinical services may result in lower overall payments made for clinical care,” wrote Neeraj Sood, PhD, director of research at the Leonard D. Schaeffer Center for Health Policy & Economics at the University of Southern California, and colleagues.

Researchers from San Francisco-based Castlight Health, a healthcare management technology company, assisted in the study, which focused on the use of Castlight’s price transparency platform. Medical claims from 2010-2013 for more than 500,000 employees who worked for one of 18 large, self-insured employers with access to the transparency platform were analyzed. Sood and colleagues aimed to compare payments for clinical services, including advanced imaging, between patients who searched the pricing website and those patients who did not search.

Nearly 7 percent of the 76,768 advanced imaging claims in the study were associated with a prior search on the transparency platform. Results showed that following access to the platform, relative claim payments for searchers were 13.15 percent lower than for nonsearchers.

This reduction amounted to an absolute payment difference of $124.74 per advanced imaging test.

Sood and colleagues pointed out that the study could not determine whether patients were making “better” decisions, since it could not capture quality of care or other nonprice attributes. They called for more research into whether such price transparency technology can reduce overall healthcare spending beyond simply lowering claim payments for services measured in their analysis.

“It is possible that these tools might also affect use of care,” they wrote. “For example, knowing that some prices are very high, some patients may forego care. Conversely, cost savings from price shopping might enable patients to increase use, which may lead to improved adherence to recommended treatments but also to overuse of services.”