Pioneer Institute National Survey Finds Limited Access To Price Estimates For Routine Hospital Procedure

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Researchers found price for MRI of knee ranges from $400 to $4,544

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.

A survey of 54 hospitals in six metropolitan areas across the United States reveals that consumers seeking a price estimate for a routine medical procedure face a difficult and frustrating task, despite price transparency provisions in the Affordable Care Act and five of the six states, according to a new Pioneer Institute Policy Brief.

For “Healthcare Prices for Common Procedures Are Hard for Customers to Obtain: Survey finds hospitals not prepared to give price information to consumers,” researchers called hospitals in and around Des Moines, IA, Raleigh-Durham, NC, Orlando, FL, Dallas-Ft. Worth, TX, New York, NY and Los Angeles, CA asking for the price of an MRI of the left knee without contrast. For 57 percent 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, researchers had to call a separate number or organization to obtain an estimate for the reading fee.

Watch: Report authors Barbara Anthony and Scott Haller interviewed on nationally syndicated investigative news program, “Full Measure.” Also covered in Modern Healthcare: "Hospital prices are still hard to come by (and not very useful)".

“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 Pioneer Institute Senior Fellow in Healthcare Barbara Anthony, who wrote the report with assistance from Scott Haller. “We must create a culture of consumer-friendly price transparency in healthcare.”

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. They experienced long waits on hold, had to call multiple times and leave messages, endured multiple transfers and ultimately a number of dropped calls.

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 healthcare marketplace.”

The following nine of the hospitals did very well and appeared to have systems in place to provide price information in a relatively organized, consumer-friendly way:

The Iowa Clinic, Des Moines
Dr. P. Phillips Hospital, Orlando
Dallas Regional Medical Center
Cedars Sinai, Los Angeles
NYU Langone, New York
Mount Sinai, New York
Wake Med Cary Hospital, Raleigh/Durham
Duke University Hospital, Raleigh/Durham

Anthony and Haller recommend that governments, providers and insurance carriers educate consumers on the importance of price transparency. They also call on hospitals to train their staff on how to handle price estimate requests. With guidance from the federal government, hospitals should also make price information more accessible on their websites.

Barbara Anthony, a lawyer, is a senior fellow in healthcare at Pioneer Institute focusing on healthcare price and quality transparency. She is also a senior fellow at the Harvard Kennedy School’s Center for Business and Government. She served as Massachusetts undersecretary for Consumer Affairs and Business Regulation from 2009 to 2015.

Scott Haller is a senior at Northeastern University pursuing a degree in political science. He began working at Pioneer through Northeastern’s Co-op Program and has continued as a research assistant.

Pioneer Institute is an independent, non-partisan, privately funded research organization that seeks to improve the quality of life in Massachusetts through civic discourse and intellectually rigorous, data-driven public policy solutions based on free market principles, individual liberty and responsibility, and the ideal of effective, limited and accountable government.

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Micaela Dawson
Pioneer Institute
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