The Collective Blog of Health IT
Episode 265 - Making Change: Turning Price Transparency Into Health Care Savings

Health care price transparency has become an increasingly important part of the conversation around affordability. But knowing what health care costs is not necessarily the same as knowing what to do about it.

That was one of the central themes of a recent Collective Voice of Health IT podcast (#265) conversation with Dr. Ronald Dixon, founder and CEO of CareHive. Their discussion explored a deceptively simple question: Where are we getting our care?

The same test, procedure, or service can have dramatically different costs depending on where it is delivered. For patients facing higher out-of-pocket expenses, choosing a more cost-effective site of care could potentially make a meaningful difference. But simply publishing a list of prices doesn't necessarily make that choice easy.

Transparency Is Only the Starting Point

Dr. Dixon, a physician and general internist, said his interest in the issue grew from conversations with his own patients. Patients would sometimes ask whether they could have a test performed somewhere less expensive. His response was straightforward: if the test is medically appropriate, why shouldn't the patient have the option of getting it somewhere more affordable?

The challenge is that health care decisions are complicated. Patients generally trust their clinicians and want to follow their recommendations. Asking them to simultaneously evaluate prices, compare locations, determine what is appropriate and then navigate the logistics of changing where a service is performed can place a significant burden on the patient.

As Dixon put it, simply posting costs online and telling patients to figure it out themselves is asking a lot.

The next step, he argues, is actionable transparency—using information about cost to actually help patients make a different choice.

Turning Information Into Action

That is where technology can play a role.

Rather than simply presenting patients with a database of prices, Dixon described an approach that uses claims information to personalize potential savings. A patient could see, for example, that they might have saved hundreds of dollars by receiving laboratory or imaging services at a different facility.

But the process doesn't necessarily end with showing the savings.

CareHive can help identify alternative locations, take geographic and personal preferences into account, and assist with the next steps. For patients who are comfortable using technology, that may mean navigating the options digitally. For others, a human navigator can help them through the process.

The distinction is important: the goal isn't to turn patients into health care pricing experts. It's to make the information useful enough that they can act on it.

Preserving Trust Between Patients and Clinicians

Another important theme from the conversation was the role of the clinician.

Price transparency shouldn't require patients to question whether their doctor has recommended the right test or treatment. Dixon emphasized that CareHive is not trying to second-guess clinical decisions. Instead, the objective is to help patients make more informed choices about where to receive care that their clinician has already recommended.

That distinction can be particularly important for services such as laboratory testing and radiology, where there may be multiple appropriate locations and significant differences in cost.

The clinician-patient relationship remains central. The opportunity is to give patients another question they can comfortably ask:

“I trust your recommendation. Can I get this somewhere less expensive?”

From Individual Savings to Systemic Change

The implications extend beyond an individual patient's wallet.

Dixon believes that helping patients identify and choose more cost-effective sites of service could create broader market effects. Patients need healthcare services—laboratory tests, imaging, urgent care and other forms of treatment—but they don't necessarily need to receive those services at the most expensive available location.

If patients have better information and practical support for acting on that information, their choices could create greater demand for cost-effective sites of care.

That also points to another piece of the health care information puzzle: accurate provider and facility directories. Knowing that a lower-cost option exists isn't particularly useful if patients can't determine whether the location is active, appropriate, accessible or capable of providing the service they need.

For Dixon, connecting cost information with accurate information about where care is available represents a potential next step.

Making Health Care More Affordable Without Asking Patients to Do More

Perhaps the most compelling takeaway from the conversation is that health care affordability doesn't necessarily require patients to become experts in the health care system.

Patients already have enough decisions to make when they need care. The opportunity is to use data, technology and human navigation to make better choices easier—not to shift another complicated responsibility onto the individual.

Dixon illustrated the point with a personal experience. After injuring his back, his physician recommended an MRI. Dixon knew the same service could cost approximately $400 at one location compared with $1,200 at another. He asked his physician if he could go somewhere else, and the physician was able to make it work.

The savings came not from a lack of care, but from finding a different place to receive the care that had already been recommended.

That may be the larger opportunity for price transparency: not simply showing patients that prices differ, but building the tools and connections that allow them to do something about those differences.

Health care consumers shouldn't have to become pricing experts to make more affordable choices. They need information that is understandable, actionable and connected to the care their clinicians already recommend.

And sometimes, making health care more affordable may begin with a surprisingly simple question:

Where are we getting that care?

Listen to the full conversation with Dr. Ronald Dixon on the WEDI “Collective Voice of Health IT” podcast at www.wedi.org/category/podcasts