The Impact of Hospital Price and Quality Transparency Tools on Healthcare Spending : A Systematic Review

Increasing healthcare spending and lacking of efficiency in the healthcare market have spurred government and insurers interest in hospital price and quality transparency tools. This systematic review synthesized literature examing the impact of hospital price and quality transparency tools on healthcare spending. A systematic search of seven databases was conducted and PRISMA reporting guidelines were followed. This review found that, 1) hospital price transparency tools reduced the price of lab tests and imaging services but had an insignificant impact on the price of office-visit services; 2) the implementation of hospital quality transparency tools declined the level or growth rates of healthcare price. However, for those higher-rated facilities, hospital quality information disclosure adversely and significantly raised the price of medical services and patients' medical costs; 3) holding the contract’s quality constant, hospital quality transparency tools not only leveraged private insurers to increase premiums, but also induced their anticipated pricing behavior. With regarding to mechanisms, on the demand-side, consumers did respond to price and quality transparency tools through searching for information, choosing providers, and switching plans. On the supply-side, competition and reputation mechanisms were fundamentally important, and the bargaining process was vital in healthcare systems featured by private-owned hospitals and private insurers