Potential patients more often choose quality over cost when it comes to selecting imaging services for severe health conditions, according to a survey study published February 3 in the Journal of the American College of Radiology.
A team led by Ritika Manik from Emory University in Georgia found in their study of over 1,000 survey respondents that improved the accuracy of imaging results, provider recommendations for facilities, and online ratings matter over increased costs. They also found that most potential patients prefer imaging facilities with transparent out-of-pocket costs.
"As higher quality care does not necessarily translate to higher cost care, the simultaneous availability of cost and quality measures could help consumers choose higher value providers," Manik and colleagues wrote.
Previous research suggests that 10% of Americans delayed or avoided medical care because of costs, with 137.1 million reporting medical financial hardships. Rising out-of-pocket costs for patients are being experienced in part by high-deductible insurance plans and rising treatment costs.
The U.S. Centers for Medicare and Medicaid Services (CMS) in 2021 mandated price transparency rules, in which all hospitals must have charges available in machine-readable file formats. Potential patients meanwhile should be able to access out-of-pocket costs through self-service tools offered by online health plans by 2024.
While the goal for these rules is to promote price comparison and competition, researchers said "many" price transparency tools omit metrics on care quality.
"Few tools that include these metrics demonstrate that quality metrics are vital to optimizing consumer engagement with and deriving benefits from these tools," they wrote. "Moreover, evidence is scant regarding patient trade-offs for service cost over perceived quality, particularly for imaging."
Manik et al wanted to see how potential patients weigh out-of-pocket costs for imaging services versus measures of quality when selecting an imaging center. They used back pain as a hypothetical health condition, with MRI as the imaging method in a survey with 1,025 respondents.
| Quality vs. cost in choosing imaging centers for potential patients with severe back pain | |||
| Lower cost (odds ratio) | Higher quality (odds ratio) | Relative importance for quality | |
| Accuracy (96% vs. 87%) | 2.95 | 8.03 | 65.8% |
| Provider recommendation | 2.97 | 6.86 | 63.9% |
| Online rating (4.5 vs. 2.5 stars) | 1.70 | 8.61 | 80.1% |
The team also found that survey participants were willing to pay over $50 for higher quality when it came to severe back pain, which ranged between $619 and $1,403 for care.
However, no statistical differences between the importance of cost and quality were reported for mild back pain.
Along with improving price transparency, researchers called for out-of-pocket cost information to be delivered through best practices, as well as "enterprise-wide provider-level" financial awareness for patients in more vulnerable populations.
The study authors also called for future studies to identify the most comparable and easily obtainable metrics across imaging centers that remain important to patients.
"Incorporating comparable and easily obtainable quality measures in price transparency tools may enhance patients' medical decision making," they wrote.
