A survey of 54 hospitals in six metropolitan areas across the U.S. has revealed that consumers seeking a price estimate for a routine medical procedure can face a frustrating task despite price-transparency provisions in the Patient Protection and Affordable Care Act, according to a new policy brief from the Pioneer Institute, a privately funded research organization based in Massachusetts.
In the survey, researchers called hospitals in and around Des Moines, Iowa; Raleigh-Durham, North Carolina; Orlando, Florida; Dallas–Fort Worth, Texas; New York, New York; and Los Angeles, California, asking for the price of a magnetic resonance imaging (MRI) scan of the left knee without contrast. For 57% of the hospitals, it took more than 15 minutes to get a complete price that included the radiologist’s fee for reading the MRI. Two-thirds of the time, the researchers had to call a separate number or organization to obtain an estimate for the reading fee.
“With the rise of high-deductible health plans, the wide variations in price, and the fact that in the areas surveyed there are 15 million uninsured people, it’s more important than ever for consumers to have access to accurate price information,” said co-author Barbara Anthony, a senior fellow in health care at the Pioneer Institute. “We must create a culture of consumer-friendly price transparency in health care.”
Complete price estimates could not be obtained from 14 of the 54 hospitals, despite as many as 11 calls. Of the 40 hospitals that provided complete information, MRI price estimates ranged from $400 at Huntington Hospital in Los Angeles to $4,544 at New York City’s Montefiore Medical Center.
It was clear to the researchers that front-line employees at most of the hospitals had no idea what to do with price requests. The researchers experienced long waits on hold, had to call multiple times and leave messages, endured multiple transfers, and ultimately experienced a number of dropped calls, according to the report.
Almost none of the hospital websites provided easy access to price information.
“The fact that there are people with high-deductible health plans who are foregoing care rather than value shopping has led some to conclude that consumers aren’t interested in price data,” said Pioneer Institute Executive Director Jim Stergios. “But the real issue is that price information isn’t readily available in the health care marketplace.”
Anthony recommends that governments, providers, and insurance carriers educate consumers on the importance of price transparency. They also call on hospitals to train their staffs on how to handle price-estimate requests. With guidance from the federal government, hospitals should also make price information more accessible on their websites, Anthony said.
Source: Pioneer Institute; February 21, 2016.