Catalyst for Payment Reform

Evaluating Transparency Tools


Evaluating Transparency Tools

What is a Price Transparency Tool?

A price transparency tool is typically a website that contains information for consumers about the prices of various health care services from different health care providers that can help them make a more informed decision about what health care they want to seek from which provider.  Sometimes this information is provided in other formats such as mobile apps, health coaching services, or telephonically.  These tools are currently offered by all major health plans, a variety of vendors, and by some states that collect this information from local payers or providers and share it with the public. Most tools contain information about hospitals and physicians, a wide range of services, quality information, and the consumer’s share of costs.


Why should employers and other health care purchasers evaluate tools?

Many employers and other purchasers have adopted benefit designs and other health care strategies that create incentives for employees to select the highest value providers.  To realize savings from these strategies, they need to provide tools that successfully engage their employee population and provide the relevant information needed to guide decision making.

Today, all major national health plans provide members with transparency tools and up to 84% of employers could be offering tools by 2018.[1] Whether health care purchasers already offer a tool or are thinking of offering one, they need to understand how to evaluate whether a tool can help them achieve their goals. This can help with deciding whether to rely on a contracted health plan’s tool, to procure a tool offered by an independent vendor, or how to push for improvements to tools.


What criteria should employers use to evaluate tools?

CPR has developed specifications that govern which features should be present in an adequate transparency tool.  There are five major categories employers should consider when evaluating a tool:

  • Scope: Tools possess an adequate breadth of information (e.g., services, regions, procedures, providers)
  • Quality: Tools leverage quality measures relevant to employers and consumers, displaying them in understandable ways
  • Price Accuracy: Tools displays accurate price data broken down in useful ways for consumers (e.g., by service, by episode)
  • Usability: Tools are designed to facilitate ease of use for consumers by providing a search function and customer support
  • Engagement: Tool provider employs communication, education, and other engagement strategies to drive usage


What are the latest findings from evaluations of existing eools?

Price and quality transparency tools are widespread, but it is unclear if the presence of these tools will result in savings for employers or better quality care for consumers.

  • Engagement is generally low. Studies cite anywhere from 5% – 10% utilization among those who have access to a tool. As a result, consumer access to such tools has not yet been proven to result in lower spending.[2]
  • Availability and accuracy of price information varies widely by market, typically because of contractual terms between payers and providers regarding negotiated payment amounts and whether or not that information can be released.
  • Consumers primarily use the tool to shop for a limited set of “shoppable” services, such as pregnancy or MRIs[3].
  • Gaps remain in the availability of quality data, making it hard for consumers to compare options based on the combination of cost and quality.[4]

Want to learn more? Check out these additional resources