Getting more out of healthcare
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Surveys of Americans consistently rate the high cost of medical care as a chief complaint about the U.S. system. Betsy Cliff, PhD, assistant professor of health policy and administration, focuses her research on addressing solutions to high healthcare spending. Americans with commercial health insurance face higher prices than in other nations, she notes, and many medical services that people use don’t actually improve health, a cause of wasted spending.
Cliff’s research is investigating health service utilization, highlighting how to transform the U.S. healthcare system to provide better value.
“A basic idea that translates from other markets is that if you make healthcare more expensive, people use less of it,” Cliff said. “But, as healthcare is becoming more expensive, we realize that may have negative impacts on health. In fact, there are some healthcare services we really want to encourage people to use and certain services that we want to discourage.”
Cliff noted that sometimes imaging scans, pre-operative workups or lab tests are ordered but don’t give physicians and patients useful information.
She searches for ways to target consumer incentives, like health insurance design, to drive better value in health. Patients are asked to pay for part of the cost of their care in two ways: regular premium payments and service-based payments for visiting the doctor or filling a prescription. Tweaking these elements of cost sharing, particularly service-based payments, could increase the use of preventive services, such as medications for chronic disease or screenings like mammograms and colonoscopies.
Cliff is also investigating how prices for healthcare services impact consumer behavior. Cliff compares a car dealership to hospital services: if a dealership is charging four times as much as one down the road, the less expensive dealership is likely to win business. A hospital charging four times as much for comparable services is not likely to see a significant change in volume of business.
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Most people don’t know how to price shop. Most large commercial insurers have price shopping tools on their websites, but people don’t know they exist.
| Assistant Professor of Health Policy and Administration
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Whether consumers would engage in this behavior remains an open question, but price comparisons need to be made easy and accessible.
“In the United States, we value the ability to choose providers and purchase the medical care we want,” Cliff said. “My research speaks to whether that results in better healthcare quality and affordability for the entire population.”