- Association Between Viewing Health Care Price Information and Choice of Health Care Facility October 2016
Price information in combination with insurance benefit design that shares savings when patients choose low-cost health care facilities (e.g., reference pricing) has led to lower spending; however, the impact of price information on patient choices for patients in commercial insurance without such benefit design incentives is largely unknown. In a HCFO-funded study, Anna Sinaiko, Harvard T.H. Chan School of Public Health, and colleagues examined the impact of Aetna’s web-based, real-time, personalized episode-level price transparency tool on choice of health care facility for 8 services.
- ACOs Holding Commercial Contracts Are Larger And More Efficient Than Noncommercial ACOs October 2016
Accountable care organizations (ACOs) have diverse contracting arrangements and have displayed wide variation in their performance. Using data from national surveys of 399 ACOs, the researchers examined differences between the 228 commercial ACOs (those with commercial payer contracts) and the 171 noncommercial ACOs (those with only public contracts, such as with Medicare or Medicaid).
Commercial virtual visits, new methods by which patients can request live consultations with physicians over the Internet, have become increasingly popular, with one company noting a user base approaching 6 million. However, the relatively new telemedicine companies, which are designed to bridge the gap—physical and otherwise—between providers and patients must be held accountable for the quality of care they provide. In a HCFO-funded study, R. Adams Dudley, M.D., M.B.A., University of California, San Francisco (UCSF) and colleagues performed an audit study to assess the quality of care provided by the eight direct-to-consumer virtual care websites with the highest web traffic.
Little is known about how primary care physicians (PCPs) in routine outpatient practice use paid price information (i.e., the amount that insurers finally pay providers) in daily clinical practice. In this HCFO-funded study, the researchers used semi-structured interviews and qualitative analysis to describe the experiences of PCPs who have had paid price information on tests and procedures for at least one year.
- Price Transparency Tool Attracts Users But Does Not Lead to Use of Lower-Priced Services September 2016
This brief summarizes findings from a study’s evaluation of a large Midwestern health information technology firm that offered their employees a price transparency tool.
- Association of Reference Pricing for Diagnostic Laboratory Testing With Changes in Patient Choices, Prices, and Total Spending for Diagnostic Tests July 2016
Prices for laboratory and other clinical services vary widely. Employers and insurers increasingly are adopting “reference pricing” policies to create incentives for patients to select lower-priced facilities. In this HCFO-funded study, the researchers measured the association between implementation of reference pricing and patient choice of laboratory, test prices, patient out-of-pocket spending, and insurer spending.
Tiered physician networks are a managed care network design used by payers to contain health care costs and improve value in the health care system. Prior studies found that tiered provider networks channel patients to preferred providers in certain contexts. This paper evalautes whether the effects of tiered physician networks vary for different types of patients.
This executive summary provides an overview of the discussion from a May 2016 meeting where RWJF grantees presented some of the key findings from their research on the use and impact of price data in health care to a panel of experts actively engaged in developing and using health care price information.
- Understanding the Use and Impact of Price Transparency in Health Care: Where Are We and Where Do We Go from Here? July 2016
This issue brief summarizes the discussion from a May 2016 meeting where RWJF grantees presented some of the key findings from their research on the use and impact of price data in health care to a panel of experts actively engaged in developing and using health care price information.
- How ACO Organizational Characteristics Affect Preventive Care Quality: Lessons from ACOs’ First Year June 2016
Accountable Care Organizations (ACO) emerged as a novel payment model to create a coordinated health system whereby providers contract together to take collective responsibility for managing the cost and quality of care for a population of patients. Preventive care is critical to ACO success. Evaluating ACOs’ strategic choices in terms of their organizational structure and early performance provides an avenue to a better understanding of the factors behind preventive care quality. In a HCFO-funded study, Valerie Lewis, Ph.D., of Dartmouth College and colleagues conducted a cross-sectional study examining Medicare Shared Savings Program and Pioneer ACO Program participants and the association between preventive care quality performance and ACO characteristics to inform strategies for preventive care quality management.