If you’ve ever tried to comparison shop for hospital and doctor prices online, then you already know what a major new study has confirmed: Patient access to healthcare price tags is limited and there are few publicly available tools to help patients get the best bang for their buck.
The study, published in the Journal of the American Medical Association, follows the federal government’s recent release of hospitals' charges for procedures and services, but concludes that kind of information won't likely help consumers trying to compare their care options.
The findings point up the need for greater transparency in medical pricing, say the researchers from the Department of Veterans Affairs Center for Clinical Management Research and the University of Michigan Health System.
"There's growing enthusiasm for improving transparency of prices for health services to help people be well-informed consumers and make better decisions about their care," said lead researcher Jeffrey T. Kullgren, M.D., health services researcher in the VA Center for Clinical Management Research. "The problem is that most of the information that's out there isn't particularly useful to the patients themselves.
"As more Americans face high levels of cost-sharing in their insurance plans, it's even more important to improve access to data that help them anticipate their out-of-pocket expenses and evaluate their options."
The study is based on an analysis of 62 state websites that aim to help patients estimate or compare prices for healthcare services. It found most sites only reported billed charges, not what patients were actually expected to pay. The review also found most websites focused on prices for in-hospital care, which patients often can’t plan for, and rarely included prices for outpatient services like laboratory or radiology tests that are often predictable or less urgent, and therefore more "shoppable."
What’s more, most patient resources didn't provide information on quality of services alongside price information.
"Obviously if you have a heart attack or another emergency that sends you to the hospital, you're not going to be researching prices of services ahead of time," Kullgren says. "But if you know you're due for a routine lab test, a radiology test, or an outpatient procedure that you will have to pay for, you often have time to assess the options. Unfortunately prices for those types of services are seldom available."
Some sites, such as the New Hampshire HealthCost website, stood out as bright spots. The website allows patients to plug in their health insurance plan to receive a customized estimate of what certain healthcare services would cost them at different facilities in their community. But such standouts were rare, Kullgren said.
"We've definitely come a long way in increasing transparency about cost and quality for consumers in the last decade, but we're still not reporting the key information patients need to maximize the value of their health care spending," Kullgren said. "We aimed to identify opportunities for improvement so that we can better empower people to choose the care that's right for them."
The study was funded by the Department of Veterans Affairs Health Services Research and Development Service and the Robert Wood Johnson Foundation.
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