This study of self-pay markets and medical procedures, funded by the California HealthCare Foundation and featured as a Health Affairs Web Exclusive, finds that even when patients must pay the full cost of medical care out of pocket, they do limited comparison shopping for the lowest-cost, highest-quality care.

Based on interviews with industry experts, providers, professional associations, and regulators, the study takes an in-depth look at the LASIK market, widely regarded as the self-pay market with the most favorable conditions. It also briefly examines self-pay markets for in vitro fertilization, cosmetic rhinoplasty, and dental crowns.

It finds that while consumer price motivation should be strong when patients are shouldering the full cost of care, there are many barriers to comparison shopping, even when a procedure is relatively straightforward. For example, when researching LASIK surgery, patients often face hurdles including inconsistent bundling of charges included in the total price, misleading advertising, and quality concerns.

While markets for self-pay procedures such as cosmetic surgery are held up as models of consumer engagement that could help rein in spiraling costs and spur quality improvements, patients often simply rely on word-of-mouth recommendations to choose providers.

The complete article is available free of charge on the Health Affairs site listed under External Links.