Another challenge is the belief by some consumers that higher prices mean higher quality, which studies don't bear out.
Even with incentives, the programs face what may be their biggest challenge: simply getting people to use a shopping tool.
Kentucky state spokeswoman Jenny Goins said only 52 percent of eligible employees looked at the shopping site last year -- and, of those, slightly more than half chose a less expensive option.
"That's not as high as we would like," she said.
Still, state workers in Kentucky have pocketed more than $1.6 million in incentives -- and the state said it has saved $11 million -- since the program began in mid-2013.
Deductibles, the annual amounts consumers must pay before their insurance kicks in and are usually $1,000 or more, are more effective than smaller shopping incentives, say some policy experts.
In New Hampshire, it took a combination of the two.
The state rolled out the payments for shopping around -- and a website to look for best prices -- in 2010. But participation didn't really start to take off until 2014, when state employees began facing an annual deductible, said Deputy Commissioner Keane.
Still, the biggest question is whether these programs ultimately cause providers to lower prices.
Anecdotally, administrators think so.
Kentucky officials report they already are witnessing a market response because providers want patients to have an incentive to choose them.
"We do know providers are calling and asking, 'How do I get my name on that list' (of cost-effective providers)?" said Kentucky spokeswoman Goins. "The only way they can do that is to negotiate."
(Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.)
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