Just Because (Most) Hospitals Are Publishing Charges Does Not Mean Prices Are More Transparent

Mullens, Cody L.; Hernández, J; Anderson, Evan D.; Allen, Lindsay

doi:10.2196/14436

Cited by 8 publications

(9 citation statements)

References 10 publications

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“…Releasing the DRG chargemasters on the internet was met with little resistance from hospitals, as the information did not compromise revealing negotiated hospital pricing strategies vis-à-vis third-party payors or competitors. Although there was little resistance to the first federal regulation, previous literature has shown an abundance of nonprice-transparent and noncompliant hospitals and hospitals with inaccessible pricing information [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Analysis of Hospital Quality Measures and Web-Based Chargemasters, 2019: Cross-sectional Study

Patel¹,

Mazurenko²,

Ford³

2021

JMIR Form Res

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Background The federal health care price transparency regulation from 2019 is aimed at bending the health care cost curve by increasing the availability of hospital pricing information for the public. Objective This study aims to examine the associations between publicly reported diagnosis-related group chargemaster prices on the internet and quality measures, process indicators, and patient-reported experience measures. Methods In this cross-sectional study, we collected and analyzed a random 5.02% (212/4221) stratified sample of US hospital prices in 2019 using descriptive statistics and multivariate analysis. Results We found extreme price variation in shoppable services and significantly greater price variation for medical versus surgical services (P=.006). In addition, we found that quality indicators were positively associated with standard charges, such as mortality (β=.929; P<.001) and readmissions (β=.514; P<.001). Other quality indicators, such as the effectiveness of care (β=−.919; P<.001), efficient use of medical imaging (β=−.458; P=.001), and patient recommendation scores (β=−.414; P<.001), were negatively associated with standard charges. Conclusions We found that hospital chargemasters display wide variations in prices for medical services and procedures and match variations in quality measures. Further work is required to investigate 100% of US hospital prices posted publicly on the internet and their relationship with quality measures.

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Section: Introductionmentioning

confidence: 99%

Analysis of Hospital Quality Measures and Web-Based Chargemasters, 2019: Cross-sectional Study

Patel¹,

Mazurenko²,

Ford³

2021

JMIR Form Res

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“…Many health care price transparency initiatives and tools have been developed to encourage patients to shop for more cost-effective care and decrease health care spending but have yielded low awareness, offered limited information, and had little evidence that they meaningfully influenced patient behavior. 2 , 3 , 4 , 5 , 6 , 7 , 9 , 10 , 11 For example, some state-level price transparency tools have focused on publishing within-hospital mean prices, but these aggregated prices are not necessarily relevant to individual patients. 2 Other initiatives required hospitals to publish charges, but those amounts rarely reflect the actual costs of care or potential cost-sharing responsibility for insured patients.…”

Section: Discussionmentioning

confidence: 99%

“… 2 Other initiatives required hospitals to publish charges, but those amounts rarely reflect the actual costs of care or potential cost-sharing responsibility for insured patients. 10 Moreover, most price transparency tools offer price estimates for individual health care services (eg, a single procedure code), but not prices for entire episodes of care. 2 , 10 Owing to these limitations and poor communication about them to patients, uptake of price transparency tools has been low 3 , 4 , 6 , 7 and their availability has not been associated with lower health care spending.…”

Section: Discussionmentioning

confidence: 99%

“…However, obtaining meaningful price information before receiving care has historically been difficult for patients, and existing price transparency tools have struggled to gain traction. 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 To improve health care price discovery, the Centers for Medicare & Medicaid Services (CMS) issued a rule requiring that hospitals share payer-specific negotiated prices for selected shoppable health care services defined by CMS as services that “can be scheduled by a health care consumer in advance,” by January 2021. 13…”

Section: Introductionmentioning

confidence: 99%

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Concordance of Disclosed Hospital Prices With Total Reimbursements for Hospital-Based Care Among Commercially Insured Patients in the US

2021

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Key Points Question Are prices of hospital services disclosed under the new federal hospital price transparency rule correlated with total costs of hospital-based care among commercially insured individuals? Findings In this cross-sectional study of 4 545 809 hospital-based encounters for shoppable care in 2018, health care entities that billed for their services independently from the hospital were frequently involved in care delivery, and their reimbursements comprised substantial portions of the total costs of care. The disclosed hospital prices were weakly correlated with the reimbursements of independent health care entities. Meaning These findings suggest that prices disclosed under the new regulation may have limited value to patients attempting to make cost-conscious health care choices.

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“…Even if located, the posted charges are often in a machine-readable format (e.g. Microsoft Excel file) and embedded in a slew of medical codes and confusing abbreviations (Mullens et al, 2020). Lastly, in the 'Private' group, only 6% display the price of sperm cryopreservation online.…”

Section: Discussionmentioning

confidence: 99%

Assessing online price transparency of sperm cryopreservation across the United States

Farber

Cai

et al. 2021

Andrologia

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Although the lack of information on the costs and pricing of healthcare services prevails throughout the medical industry, empiric observations have demonstrated that pricing information is even more obscured in the sperm cryopreservation market. Thus, the objectives of our study are to assess and compare online price transparency and the price of sperm cryopreservation across various healthcare settings in the United States. This study examined online pricing published by facilities that have an active registration to store spermatozoa with the Food and Drug Administration. Less than one-fifth of registered facilities display any pricing information online. Price transparency also varies among census regions and facility types. Nationally, the median initial bank fee and annual price of storage are $350 and $385 respectively. Although there were no differences in the initial fee by facility type and census region, the annual price of storing spermatozoa is highest in the Northeast, which could be attributed to laboratory techniques, demographic patterns or insurance coverage. Guidelines from professional societies or different legislation and regulatory requirements across different US states can increase price transparency, which can promote consumer decision-making and decrease the barrier for men seeking fertility preservation.

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Just Because (Most) Hospitals Are Publishing Charges Does Not Mean Prices Are More Transparent

Cited by 8 publications

References 10 publications

Analysis of Hospital Quality Measures and Web-Based Chargemasters, 2019: Cross-sectional Study

Analysis of Hospital Quality Measures and Web-Based Chargemasters, 2019: Cross-sectional Study

Concordance of Disclosed Hospital Prices With Total Reimbursements for Hospital-Based Care Among Commercially Insured Patients in the US

Assessing online price transparency of sperm cryopreservation across the United States

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