(Reuters Health)—You might not get what you pay for when it comes to healthcare, a new study hints.
A report in Health Affairs on May 2 found little association between how much physician practices charged and patients’ perceptions of their quality of care.1
“We’re asking consumers to make a lot of decisions about healthcare purchasing without a lot of information. Price is not really a definitive signal of quality,” says lead author Eric T. Roberts, a health-services researcher at Harvard Medical School in Boston.
“Practices with higher prices perform no better in terms of patients’ ratings of their care,” he says in a phone interview.
Working with nationwide databases, Roberts and his team looked at the fees practices had negotiated with commercial insurance companies. On average, high-price practices charged $84.45 for an office visit—36% more than the charge at the average low-price practice, the study found.
Roberts and colleagues then looked at survey data and insurance claim information from more than 31,000 patients at those same practices who were insured through Medicare, the federal insurance policy for the elderly and disabled.
The researchers studied these patients because, under Medicare, the government sets non-negotiable fees. Medicare patients would have been unaware of the price differential and therefore would have been free from any influence of knowing the cost, making it easier for researchers to tell whether practices that negotiated above-average prices with commercial insurers for their non-Medicare patients delivered better care in general.
Medicare patients in high-price practices did report better coordination and management of their care, were more likely to see doctors within 15 minutes of scheduled appointments and were slightly more likely to receive flu and pneumonia vaccines. Otherwise, however, based on their survey responses, they didn’t feel they received more valuable care than patients in lower-price practices in the same geographic areas.
Researchers found no significant differences in overall ratings of care or doctors, timely access to care and interactions with primary physicians. Higher prices failed to lead to fewer hospitalizations, and patients in high-price practices were no more likely to get mammograms or other preventive or acute care.
The study debunks the myth that more expensive healthcare is superior healthcare, says Martin Gaynor, an economics and health policy professor at the Heinz College at Carnegie Mellon University in Pittsburgh.
“Don’t just assume that because this practice is more expensive, the care is going to be better,” Gaynor, who was not involved with the study, says in a phone interview. “There’s no consistent finding across the board that quality is better for patients who go to more expensive practices.”