Colonoscopies and mammograms top list of 'most-shopped' health care services

Colonoscopies, mammograms, and childbirth services are the most searched-for medical services when it comes to cost information—and millennials with higher annual deductible spending are the most frequent comparison shoppers—according to an analysis of a large national health insurance plan database by researchers from Harvard T.H. Chan School of Public Health.

The study appears in the April issue of Health Affairs.

Other top searched-for services in the study included MRIs, vasectomies, physician office visits, and other non-emergency services.

"Previous studies have not identified the medical services for which individuals are most interested in getting prices, or the characteristics of people who use transparency tools. This research gives the first detailed look at patterns of use of a sophisticated price transparency tool by individuals," said Anna Sinaiko, research scientist in the Department of Health Policy and Management.

Given the wide variation in costs for health care services among different hospitals and different doctors, the researchers wanted to know which people with access to a price transparency tool for comparing the costs of medical services would use it—and how. They looked at data from adults aged 19-64 who had health insurance with Aetna, a major national insurer, to evaluate how patients used the tool, called the "Member Payment Estimator," in 2011-2012.

The researchers found that 332,255 enrollees (about 3% of those who had access) used the tool. Most of the health care price information people sought was about "shoppable services"—the kind that people plan for ahead of time, such as preventive screenings or outpatient procedures like knee replacements, tonsillectomies, or hernia repair.

Most of those who used the price transparency tool were younger (in the 19-34 age range), healthier, and had higher annual deductible spending ($1,250 annually or higher) than those who didn't price shop. Women used the tool more than men. But only a small percentage of Aetna subscribers—3.5%—used it once in 2011 or in 2012.

Efforts to introduce price transparency to the U.S. health care system are on the rise. The hope is that consumers will incorporate costs into their medical decision-making and use that information to choose high-quality and high-value care. The study findings suggest that innovative approaches are needed to encourage patients to use price transparency tools to help them get more value for their health care dollar.

"Raising consumer awareness about absolute and relative prices of health care services is an important piece of the puzzle for increasing value in our system. While the tools for giving consumers meaningful price information have become quite sophisticated, increasing engagement of more patients in these efforts remains a work in progress," said co-author Meredith Rosenthal, professor of health economics and policy.