Most Americans don’t believe that the price of healthcare services relates to the quality they receive, according to research published in Health Affairs.

Authors Kathryn Phillips, David Schliefer and Carolin Hagelskamp cite previous studies finding that higher healthcare prices don't necessarily translate into better care or outcomes. Their research, however, is not meant to assert that those who perceive a link between price and quality are misguided; rather, their nationally-representative survey examines the effects of price transparency tools and what impact they have, if any, on a consumer's choices.

To that end, between 58 and 71 percent of respondents don't see price and care as intricately linked, while eight to 16 percent said they didn't know. A substantial minority of 21 to 24 percent, meanwhile, believes there is some correlation.

Indeed, the authors discovered that respondents who had compared prices were more likely to perceive that price and quality are associated. And they called for improving price transparency tools and policies to consider how that information is communicated.

“Providing price information will not necessarily prompt consumers to choose higher-priced providers instead of lower-priced ones," the authors posit. The findings, they said, "underscore the need to report quality information alongside price information, so that consumers have some basis on which to differentiate between services and providers."

Thickening the plot, the authors explained that how a question is framed can impact people's responses. Patients may think more favorably of a surgical procedure with a 90 percent survival rate than one with a 10 percent mortality rate, for example. Although those rates are statistically identical, framing the outcome in terms of mortality stokes people's aversion to loss.

Similarly, the authors argue that people are more unhappy about losing $100 than they are happy about winning $100, which, simplistically put, is the underlying basis behind modern behavioral economic theory.

That assertion translated into the study results. Respondents who were asked about high price and high quality were consistently more likely to say that price and quality were not related, compared to those who were asked instead about low price and low quality.

Another perception expressed among respondents was that providers and insurers set prices that don't necessarily reflect the quality or cost of goods and services. Study participants attributed high prices to spending in such areas as new technology and buildings — which is perceived to be less important than short wait times and physicians who listen to patients' concerns.

"Theories and findings from behavioral economics could be applied more widely to the tools and policies intended to help healthcare consumers make purchasing decisions," they wrote. 

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