“There isn’t much of a relationship between making this information public and how people choose services,” Anthes said.
A new report by Anthes and Chloe Jen, student at Case Western Reserve University, highlighted both the wide range of prices for Ohio hospitals for the same procedures and the difficulty in accessing these prices in a meaningful way.
That’s for a range of reasons Anthes said price transparency has its limits, such as that many procedures like an emergency visit are not the type of care people can shop for. In addition, the sticker price for a procedure doesn’t tell the patient how much they will actually pay out of pocket on the final bill, since that can depend on the type of insurance plan.
Also, Anthes said health care is complicated and many patients don’t know enough about health and medicine and billing codes to meaningfully shop for value.
“If you need a bypass surgery, you need to bypass surgery. Period. It’s not like you’re going to go shop around. You’re going to go based off of things like proximity, reputation, relationship to your doctor, and, ultimately, what your insurance covers,” Anthes said.
Sarah Hackenbract, CEO of the Greater Dayton Area Hospital Association, said prices can vary from hospital to hospital for many reasons. In the Dayton region, for example, she said nearly 80% of people in local hospitals on a typical day are paying with Medicaid or Medicare, which pay much less than employer-based insurance plans.
“That cost is made up through negotiations with commercial payers,” Hackenbract said.
Hackenbract said there’s been a lot of focus on price transparency at the legislative level, but it is important to recognized that health care is much more complex.
“Consumers are not shopping as much as what we thought they might or planned for when we were building the Patient Protection and Affordable Care Act,” Hackenbract said.
Anthes said he thinks systemic reform is needed to meaningfully lower the high cost of U.S. health care and said the state has a role to play to develop better policies.
“Not only will this create a better landscape for employers who want to do business in Ohio, but it will protect consumers who rightfully expect to receive a quality service at a fair price when they need it most,” Anthes wrote in his report.