Analyzing the Impact of the Now iKnow Health Care Price Transparency Tool

This project aims to assess the impact of a web-based health care cost and quality tool that is being implemented by a health plan for its members. The study will focus on members working for medium to large employers that have more than 90% of employees enrolled in deductible and tiered network health plans. The study will use an interrupted time series (ITS) design that includes random allocation of half of these employers to a study arm that will receive enhanced promotion of the tool and a $500 lottery incentive for its use in order to increase take-up. With these two study groups (a "high-dose" group receiving enhanced promotion and a lottery, and a "low-dose" group receiving routine promotion of the tool), the study will be able to evaluate whether access to a price transparency tool leads to reduced costs and more value-driven member behavior, and whether extra promotion increases take-up.

Members in the high-dose group who use the tool will be eligible to enter a monthly lottery to win a $500 prize during the 12-month intervention period. In addition to the lottery, employers in the high-dose group will receive additional promotional strategies such as a mailing and messages through the plan's member web portal to promote the tool and the lottery, and e-mails and flyers for employers to promote the tool and lottery to employees.

The aims of this project are to: 1) examine take-up of the tool and factors that predict take-up; and 2) to examine the impact of the tool on total and out-of-pocket health care costs and utilization

Study Overview

• Status: Completed
• Conditions: no Specific Condition Targeted; Use of a Price Transparency Tool
• Intervention / Treatment: Other: lottery for tool users to win a $500 prize; Other: enhanced promotion of the tool to employers and members

• Study Type: Interventional
• Enrollment (Actual): 81000
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Massachusetts
    • Wellesley, Massachusetts, United States, 02481
      • Harvard Pilgrim Health Care

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

Health plan members from employers with at least 40 subscribers, of which at least 90% are currently in deductible plans or tiered network plans, and of which at least 80% were in deductible or tiered network plans in the prior year

Exclusion Criteria:

Members in non-group accounts and members in Medicare plans; members in states outside Massachusetts, New Hampshire, or Maine

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: lottery and enhanced promotion of tool; tool users in the intervention arm will be eligible to enter a monthly lottery to win one of two monthly drawings of a $500 gift card, and will receive enhanced promotion of the tool (mailed promotion, promotional message on the member web portal, and promotion through employers to employees)	Other: lottery for tool users to win a $500 prize; Intervention group is eligible to enter a monthly lottery to win a $500 gift card if they use the tool each month.; Other: enhanced promotion of the tool to employers and members; Intervention group also receives extra promotion of the tool through mailings, employer outreach, and automated phone calls
No Intervention: usual promotion of the tool; Routine promotion of the tool through newsletter and on health plan web site

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
mean per-member-per-month total health care costs	employer level per-member-per-month total costs based on claims data	monthly for 12 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
percent of subjects using the tool	Based on tool usage tracking data	measured quarterly for 12 months
mean per-member-per-month out-of-pocket costs	employer level per-member-per-month out-of-pocket costs based on claims data	monthly for 12 months
per-member-per-month utilization of health care services	Employer-level utilization of health services based on claims data, including emergency department visits, encounters, lab services, radiology services, inpatient hospitalizations, MRIs, prescriptions	monthly for 12 months

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
reasons for using the tool	based on survey report	measured with each use of the tool, over 12 months

Collaborators and Investigators

• Sponsor: Alison Galbraith
• Collaborators: National Institute on Aging (NIA); Massachusetts Institute of Technology; Harvard Pilgrim Health Care; National Bureau of Economic Research, Inc.
• Investigators: Study Director: Alison Galbraith, MD, MPH, Harvard Pilgrim Health Care Institute and Harvard Medical Schooll; Principal Investigator: Jonathan Gruber, PhD, Massachusetts Institute of Technology

Study record dates

Study Major Dates

• Study Start: August 1, 2014
• Primary Completion (Actual): December 1, 2015
• Study Completion (Actual): December 1, 2015

Study Registration Dates

• First Submitted: January 31, 2014
• First Submitted That Met QC Criteria: January 31, 2014
• First Posted (Estimate): February 4, 2014

Study Record Updates

• Last Update Posted (Estimate): August 19, 2016
• Last Update Submitted That Met QC Criteria: August 18, 2016
• Last Verified: August 1, 2016

More Information

Terms related to this study

• Keywords: health care costs; quality of health care
• Other Study ID Numbers: 5P30AG012810-20 (U.S. NIH Grant/Contract); 5P01AG005842-27 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO