Association Between Availability of a Price Transparency Tool and Outpatient Spending
Association Between Availability of a Price Transparency Tool and Outpatient Spending
复制标题
DOI：
10.1001/jama.2016.4288
复制
发表时间：
2016-05-03
影响因子：
120.7
通讯作者：
Mehrotra, Ateev
中科院分区：
文献类型：
--
作者：
Desai, Sunita;Hatfield, Laura A.;Mehrotra, Ateev
重要性有越来越多的兴趣，使用价格透明度工具，以减少health care spending.Objective测量之间的关联提供一个医疗保健价格透明度工具和门诊spending.Design，设置，和参与者两个大的雇主代表在多个市场领域在美国提供了一个在线的医疗保健价格透明度工具，他们的员工。一个在2011年4月1日推出，另一个在2012年1月1日推出。该工具为用户提供了关于他们将为不同医生、医院或其他临床站点的服务自掏腰包支付多少费用的信息。使用匹配的差异-无差异设计，门诊费用的员工提供的工具（n=148 655）与员工之间的其他公司没有提供的工具（n=295 983）在一年之前和之后，它被引入。结果平均门诊费用的员工提供的工具是2021美元的前一年，该工具被引入后的一年，2233美元。相比之下，在对照组中，平均门诊费用从1985美元变为2138美元。在调整人口统计学和健康特征后，提供该工具与门诊费用平均增加59美元（95%CI，25 - 93美元）相关。平均门诊自付支出在那些提供的工具是507美元的前一年引入的工具和555美元后的一年。在对照组中，平均门诊自付费用从490美元变为520美元。在调整相关因素后，提供价格透明度工具与自付支出平均增加18美元（95% CI，12 - 25美元）相关。在前12个月，10%的员工谁提供的工具使用它至少once.Conclusions和相关性在2家大公司的员工，提供一个价格透明的工具是不相关的较低的医疗保健支出。只有一小部分符合条件的雇员使用该工具。
IMPORTANCE There is increasing interest in using price transparency tools to decrease health care spending.OBJECTIVE To measure the association between offering a health care price transparency tool and outpatient spending.DESIGN, SETTING, AND PARTICIPANTS Two large employers represented in multiple market areas across the United States offered an online health care price transparency tool to their employees. One introduced it on April 1, 2011, and the other on January 1, 2012. The tool provided users information about what they would pay out of pocket for services from different physicians, hospitals, or other clinical sites. Using a matched difference-indifferences design, outpatient spending among employees offered the tool (n=148 655) was compared with that among employees from other companies not offered the tool (n=295 983) in the year before and after it was introduced.EXPOSURE Availability of a price transparency tool.MAIN OUTCOMES AND MEASURES Annual outpatient spending, outpatient out-of-pocket spending, use rates of the tool. RESULTS Mean outpatient spending among employees offered the tool was $2021 in the year before the tool was introduced and $2233 in the year after. In comparison, among controls, mean outpatient spending changed from $1985 to $2138. After adjusting for demographic and health characteristics, being offered the tool was associated with a mean $59 (95% CI, $25-$93) increase in outpatient spending. Mean outpatient out-of-pocket spending among those offered the tool was $507 in the year before introduction of the tool and $555 in the year after. Among the comparison group, mean outpatient out-of-pocket spending changed from $490 to $520. Being offered the price transparency tool was associated with a mean $18 (95% CI, $12-$25) increase in out-of-pocket spending after adjusting for relevant factors. In the first 12 months, 10% of employees who were offered the tool used it at least once.CONCLUSIONS AND RELEVANCE Among employees at 2 large companies, offering a price transparency tool was not associated with lower health care spending. The tool was used by only a small percentage of eligible employees.