Initiatives such as high-deductible health plans (HDHPs) aim to transfer risk form insurers to patients. The rationale behind this risk transfer is that when patients are in control of more funds, there will be less moral hazard and patients will use health care resources more efficiently. That is the theory, but does it bear out in reality? A paper by Mehrotra et al. (2017) aims to answer this question. Using a survey of almost 3,000 non-elderly adults in the U.S., they find that:
The majority of respondents believed that price shopping for care is important and did not believe that higher-cost providers were of higher quality. Common barriers to shopping included difficulty obtaining price information and a desire not to disrupt existing provider relationships.
It will be interesting to see whether social norms around price shopping change if HDHPs continue to grab more market share. In addition, patients often have limited information on provider quality, and because they often rely on these same physicians for referrals based on quality, price shopping may be counter-productive in the long-run if it decreases the chance that your current physician gives you a high quality referral. However, tools that provide patients with information on provider prices did not have a measurable effect on health care spending.