Healthcare pricing transparency remains elusive, study finds
Hospitals are not getting better at providing price estimates for procedures like total hip arthroplasty (THA), despite an industry push to provide that information to patients, according to a new JAMA Network report.
The study found there was no improvement in hospitals providing price estimates or reductions in the estimated price for the procedure between 2012 and 2016.
In the 2016 survey of 120 hospitals, the researchers weren't able to get any price information for THA from 44% of the hospitals.
The results are troubling, but the problem isn't a new one. CMS is considering an effort to improve transparency that includes requiring hospitals to post prices online through the Quality Payment Program proposed rule. Requiring hospitals to provide that data and adding teeth to the regulation and/or incentives to deliver healthcare price data for patients in a straightforward manner could spur improvement, but questions still remain about what prices would be posted and in what manner.
The JAMA study authors called each facility and posed as a granddaughter looking for information on the price of a primary hip replacement for her 62-year-old grandmother. The caller requested information about the lowest cash bundled price, including all hospital and physician fees. They called each hospital up to five times.
The survey wasn't able to get complete price information from most hospitals. The researchers were only able to get a bundled price from 7%, a complete price from 21% after contacting the hospital and physician office separately and a partial price (hospital or physician only) from 28%.
Though there is an emphasis on healthcare price transparency, they found the issue is actually getting worse. The percentage of hospitals that offer a bundled price declined from 16% in 2012 to 7% in 2016. Plus, the percentage of hospitals that could provide a complete price dropped from 48% to 21%, while the percentage of hospitals that weren't able to give any price information increase from 14% to 44% in that time.
“Our results provide sobering evidence that substantial efforts from government and industry to improve pricing transparency have had little tangible effect on availability of prices,” the study authors said.
Price transparency is seen as a way to improve healthcare consumerism and reduce costs. Policymakers often push for patients to shop around and find the best deal for the services they need, but this survey found that hospitals and physicians are still not providing that information to patients.
It is the latest paper to show that healthcare price transparency remains a problem. A 2017 Kaufman, Hall & Associates report said few healthcare organizations are meeting patients’ need for price information.
Another issue facing this move into healthcare consumerism is that many patients don’t seek out the price information even when hospitals and physicians provide the data. Even the rise of high-deductible health plans, which means more out-of-pocket costs for patients, isn't driving people to become better healthcare consumers.
Patient advocates have long sought more easy-to-access, understandable pricing information. If hospitals and physicians aren't able or willing to work on the issue themselves, regulation from CMS may be what it takes to force their hands.