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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Adequate Insurance.

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Strategy. Price Transparency Initiatives for Patients

Approach. Create a web-based system to inform potential patients of the price of medical procedures

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Overview. Price transparency initiatives make pricing for hospital procedures and other health care services publicly available. Most patient-focused initiatives use websites, online databases, “report cards,” for similar tools to report local hospital charges, show price variation across providers within a region, offer patients out-of-pocket cost estimates, and reveal available lower cost alternatives. Price transparency initiatives can provide comparisons to national benchmarks and include data on health care quality outcomes. Price transparency efforts can also be designed to be used by physicians, employers, health plans, and policymakers.

Evidence. Moderate Evidence. Strategies with this rating are likely to work. These strategies have been tested more than once and results trend positive overall; however, further research is needed to confirm effects, especially with multiple population groups. These strategies also trend positive in combination with other strategies. (Clarifying Note: The WWFH database calls this "some evidence").

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source. (Read more about understanding evidence ratings).

Source. What Works for Health (WWFH) Database (County Health Rankings and Roadmaps)

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Cost. This strategy helps to decrease the financial expenditure incurred by individuals, healthcare systems, and society in general for healthcare services.
  • Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.
  • Social Determinants of Health. This strategy advances economic, social, and environmental factors that affect health outcomes. SDOH include the conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Health Teaching (Education and Promotion) (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Community-Focused

Examples from the Field. Access descriptions of ESMs that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort ("What/how much did we do?")

PROCESS MEASURES:

  • Number of hospitals and healthcare providers that submit pricing data for use in the web-based system. (Measures the level of participation and data availability)
  • Number of user-friendly features and tools incorporated into the web-based system (e.g., cost calculators, quality ratings). (Assesses the system's functionality and value for consumers)

Quadrant 2:
Measuring Quality of Effort ("How well did we do it?")

PROCESS MEASURES:

  • Percent of hospitals and providers in the state that participate in the price transparency system. (Assesses the level of industry buy-in and cooperation)
  • Percent of website users who rate the system as easy to understand and navigate. (Measures user-friendliness and usability of the price transparency tool)

Quadrant 3:
Measuring Quantity of Effect ("Is anyone better off?")

PROCESS MEASURES:

  • Number of partnerships established with employers, insurers, and consumer groups to promote the price transparency system. (Engages key community partners in driving utilization)
  • Number of policymaker briefings for reports highlighting the impact and potential savings from price transparency. (Supports promotion for system sustainability and expansion)

OUTCOME MEASURES:

  • Number of healthcare services and procedures that experience a reduction in average price after the introduction of the transparency system. (Shows the impact on moderating prices through competition)
  • Number of employers that incorporate the price transparency system into their health benefits education and decision support tools for employees. (Reflects broader adoption and integration of the system)

Quadrant 4:
Measuring Quality of Effect ("How are they better off?")

PROCESS MEASURES:

  • Percent of the state's population that has access to the web-based price transparency system. (Measures the reach and availability of the tool across the state)
  • Percent of the system's marketing and outreach efforts that are tailored to various populations. (Assesses the commitment to access and utilization)

OUTCOME MEASURES:

  • Percent reduction in price variation for common procedures across providers in the state. (Demonstrates the system's impact on promoting price consistency and fairness)
  • Percent increase in patient satisfaction with the value and affordability of healthcare received. (Reflects the ultimate goal of empowering consumers and improving the healthcare experience)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.