The impact of hospital price and quality transparency tools on healthcare spending: a systematic review

Jinyang Chen; Marisa Miraldo

doi:10.1186/s13561-022-00409-4

The impact of hospital price and quality transparency tools on healthcare spending: a systematic review

Health Econ Rev. 2022 Dec 14;12(1):62. doi: 10.1186/s13561-022-00409-4.

Authors

Jinyang Chen^{1

2}, Marisa Miraldo^{3

4}

Affiliations

¹ School of Public Administration and Policy, Renmin University of China, No.59 Zhongguan Cun Avenue, Beijing, 100872, China. jinyang.chen@ruc.edu.cn.
² Centre for Health Economics and Policy Innovation, Business School, Imperial College London, London, UK. jinyang.chen@ruc.edu.cn.
³ Centre for Health Economics and Policy Innovation, Business School, Imperial College London, London, UK.
⁴ Department of Economics and Public Policy, Business School, Imperial College London, London, UK.

Abstract

Background: Global spending on health was continuing to rise over the past 20 years. To reduce the growth rates, alleviate information asymmetry, and improve the efficiency of healthcare markets, global health systems have initiated price and quality transparency tools in the hospital industry in the last two decades. OBJECTIVE : The objective of this review is to synthesize whether, to what extent, and how hospital price and quality transparency tools affected 1) the price of healthcare procedures and services, 2) the payments of consumers, and 3) the premium of health insurance plans bonding with hospital networks.

Methods: A literature search of EMBASE, Web of Science, Econlit, Scopus, Pubmed, CINAHL, and PsychINFO was conducted, from inception to Oct 31, 2021. Reference lists and tracked citations of retrieved articles were hand-searched. Study characteristics were extracted, and included studies were scored through a risk of bias assessment framework. This systematic review was reported according to the PRISMA guidelines and registered in PROSPERO with registration No. CRD42022319070.

Results: Of 2157 records identified, 18 studies met the inclusion criteria. Near 40 percent of studies focused on hospital quality transparency tools, and more than 90 percent of studies were from the US. Hospital price transparency reduced the price of laboratory and imaging tests except for office-visit services. Hospital quality transparency declined the level or growth rates of healthcare spending, while it adversely and significantly raised the price of healthcare services and consumers' payment in higher-ranked or rated facilities, which was referred to as the reputation premium in the healthcare industry. Hospital quality transparency not only leveraged private insurers bonding with a higher-rated hospital network to increase premiums, but also induced their anticipated pricing behaviors.

Conclusion: Hospital price and quality transparency was not effective as expected. Future research should explore the understudied consequences of hospital quality transparency programs, such as the reputation/rating premium and its policy intervention.

Keywords: Healthcare spending; Information disclosure; Price transparency; Quality transparency; Systematic review; The reputation premium.

Publication types

Review

Abstract

Publication types

Grants and funding