State’s health-shopping website to debut soon
After years of delay, Massachusetts is taking another crack at a job that has proven especially tough: creating a one-stop online shop to help consumers make educated choices about their health care.
The state’s Center for Health Information and Analysis has hired a vendor to design and launch a user-friendly website that includes the average prices of dozens of common health care procedures, safety and quality measures for individual hospitals, and basic information about obtaining insurance and getting care.
The site is set to be launched by September. Its goal is to give consumers, employers, and others access to information that can help them decide where to get medical care, encouraging them to shop around, as they would for other goods and services.
Prices of common medical procedures and tests, such as MRIs, mammograms, and colonoscopies, vary widely in Massachusetts — a phenomenon that particularly hits consumers with health plans that require them to pay hundreds or thousands of dollars before their insurance kicks in.
But at least two big questions remain: Will consumers actually use the new state website? And will shining a brighter spotlight on prices really help Massachusetts control costs?
Other states and private companies have launched health-cost websites. Research suggests that tiny numbers of people actually use such tools.
In Massachusetts, for example, health insurers are already required to put cost information online, but only a few thousand of the millions of state residents with commercial health insurance have bothered to browse these sites.
Ray Campbell, who became executive director of the state agency known as CHIA last summer, remains bullish.
“It’s a tough assignment,” he acknowledged. “Transparency — a lot of people have taken a run at it. I’m not sure anybody has had a hugely satisfactory outcome. I’m actually excited. I think we have a lot of the pieces in place to have the best transparency website in the country.”
The 2006 law that mandated universal health care coverage in Massachusetts and a 2012 law aimed at controlling health spending both required the state to establish a website with information about health care prices and quality.
The state previously ran a rudimentary website that was taken down in 2015, when it was deemed useless to consumers. The effort to launch a new site then lagged as CHIA struggled to determine what kind of site to build and how much to spend on it.
Campbell made the website a priority as soon as he arrived at CHIA, even though the agency was going through budget cuts. “This seems to me a mandate we ought to embrace and run with,” he said.
He envisions the site as a tool for people to better understand health care. Instead of duplicating efforts, it will link to other sites when appropriate, Campbell said. If someone is looking to buy insurance, for example, it will link them to the state’s Health Connector. Those trying to figure out exactly what they must pay out of pocket for a surgery will be connected to their health insurer’s website.
Last month, CHIA hired RainCastle Communications Inc., of Newton, for more than $294,000 to design and launch the new website. Its president, Paul Regensburg, said the company plans to create a user-friendly site, one that will evolve and improve as users send feedback.
“We’re spending a lot of energy and focus on the user experience,” he said.
If Massachusetts gets it right, a new website could not only help consumers save money on health care, but spur health care providers to lower their prices in order to remain competitive. That could put a dent in rising health care costs, transparency advocates say.
But such a change is possible only if more people use price tools. A 2016 study of employees at two large companies found that so few people checked health care prices that the availability of the information resulted in no meaningful cost savings.
“People are generally supportive of the idea of shopping for health care prices,” said Dr. Ateev Mehrotra, a Harvard Medical School professor who worked on the study and has done other research on the transparency of medical costs. “But there are a number of fundamental barriers that make it very difficult to access that information and to use it.”
Shopping for health care, it turns out, is harder than buying a new car or a television set. Consumers often don’t know that health-cost websites exist, or forget to use them. When they do browse the sites, they often find the experience confusing and time-consuming.
And when they find varying prices, it may not be practical to do anything with the information. They may be unable to drive a long distance to save a few dollars. Or they may feel uncomfortable choosing a medical facility that wasn’t recommended by their doctor.
“The most important [reason] we heard over and over again is that it was very difficult for people to switch from providers with whom they had a relationship, or to override their primary care provider’s recommendation,” Mehrotra said.
He and others argue that publicizing prices isn’t enough to encourage people to use lower-cost facilities, unless there are other incentives: for example, health insurance plans that allow patients to save money when they use lower-cost hospitals and force them to pay more for pricey hospitals.
Some employers already do this, offering cash and other perks when their workers choose less-expensive providers.
“We need to empower consumers: Give them information, and then give them incentives to use the information,” said Jon B. Hurst, president of the Retailers Association of Massachusetts, a business group. “I’m glad CHIA is pulling the trigger on this [website]. Then we have to create real consumer incentives.”
Massachusetts doesn’t have to start from scratch in designing a website. Just across the border, New Hampshire has drawn praise for its site for prices. Launched a decade ago it was redesigned last year to include quality measures and to be more user-friendly, said Tyler Brannen, health care policy analyst at the New Hampshire Insurance Department.
“We want [patients] to be more informed consumers of health care and better able to protect themselves from financial liabilities,” he said.
New Hampshire tracks the number of people visiting the site — about 3,500 unique visitors a month — but state officials can’t say whether those clicks are from concerned consumers or people in the health care industry.
Survey results released last week by the New York nonprofit group Public Agenda showed that only 18 percent of New Hampshire residents said they had heard of the state’s health-prices website.
Barbara Anthony, a former Massachusetts undersecretary of consumer affairs, said the state’s new website can play a role in educating the public. Anthony, now a senior fellow at the Pioneer Institute, is a critic of efforts by hospitals and insurers to provide pricing information, saying they haven’t done enough.
“This isn’t something that turns on a dime,” she said. “This is going to take a while, because what you’re doing is changing the culture and the way people think about health care.”