- Despite growing calls for healthcare price transparency, few websites offer information that will help consumers make informed choices about their care, according to a research letter published online this week in JAMA Internal Medicine.
- The Duke University researchers looked at the availability of price information for four nonemergency medical interventions: cholesterol panel, magnetic resonance imaging of the brain without contrast, hip replacement and upper gastrointestinal endoscopy. The searches were conducted in eight cities using Google and Bing search engines and categorized as one of five different types of sites.
- Of the 1,346 sites that were not advertisements, 21.9% were price transparency sites relevant to the particular intervention, 28.4% linked to individual providers or clinics, 7.4% offered quality information but no prices, 27.6% offered generic information and 17.4% provided unrelated information.
Just 17% of the sites included geographically relevant price estimates, and the likelihood of finding that kind of information varied widely by intervention and location, the authors note. Moreover, most websites didn't clarify whether the price quote referred to total cost or the consumer’s out-of-pocket cost. For example, price quotes for brain MRIs in Chicago ranged from $230 to $1,950 and hip replacement ranged from $27,000 to $80,671.
The fact that so few price transparency websites came up in searches could indicate these websites aren't optimizing their outcome in search results or that payers and providers are not motivated to disclose their prices, the researchers say.
“Our findings suggest that there is substantial room for improvement in providing consumers with ready access to health care prices online,” they write. “Policy makers should consider mandating that payers and providers make these prices available to consumers. Specific policies include mandating state all-payer claims databases, and better supporting and marketing state-run price transparency website, such as the one in New Hampshire.”
It’s not clear how many Americans actively seek price information before undergoing a medical procedure or a treatment. In a recent HealthFirst Financial Patient Survey, 77% of consumers said knowing costs before treatment is either important or very important.
However, just slightly more than one-fourth of consumers in a Bucknell Institute for Public Policy national poll said they request cost information from providers. Respondents were most likely to request prices for doctor visits, outpatient services, screenings and diagnostic tests, prescription drugs and dental care and least likely to seek cost information on hospitalizations.
Adding to the problem is low consumer health literacy. According to a recent UnitedHealthcare survey, only 9% of Americans have an understanding of four basic health insurance terms — health plan premium, health plan deductible, out-of-pocket maximum and co-insurance.
Proponents of price transparency argue that better-informed healthcare consumers will make cost-conscious choices and help drive down costs. But in order to do so, they need to understand the language.
In an effort to help its residents shop for healthcare, Maryland recently launched a state website with comparative price information on common procedures: hip replacement, knee replacement, hysterectomy and vaginal delivery. Several other states, including Massachusetts and Arizona, also require insurers or medical facilities to post healthcare price information online.