Dive Brief:
- Hospitals have been required to post their prices for shoppable services online since 2021, but costs shared online rarely correlate to prices hospitals share with consumers on the phone, according to a new secret shopper survey.
- The study found wide variations when comparing hospitals’ online cash prices for childbirth and brain imaging with prices told to consumers who inquire over the phone.
- For example, researchers found five hospitals with online prices greater than $20,000 for a vaginal childbirth, but telephone prices of less than $10,000. For a brain magnetic resonance imaging scan, two hospitals said the cost was more than $5,000 over the phone, but the price tag was $2,000 online.
Dive Insight:
Hospitals are required to post a consumer-friendly display on their website of the prices of 300 shoppable services under a CMS rule finalized in 2019. The rule aimed to inject more transparency into medical prices by allowing consumers to choose more afforable sites of care.
However, the push toward price transparency has hit notable roadblocks, including a lack of standard formatting for price sharing, shoddy data and poor hospital compliance.
The new study published in JAMA Internal Medicine raises additional questions about the dependability of hospital pricing.
For the study, researchers collected cash prices online for 60 U.S. hospitals between August and October last year, before calling those hospitals and requesting the lowest cash prices for vaginal childbirths and brain MRIs.
Their results back up past research that found wide variety in pricing between different hospitals, and even within the same hospital based on a patient’s insurer. For example, the new study found online prices for vaginal childbirth posted by top-ranked hospitals ranged from $0 to $55,221.
The findings also suggest hospitals may not even know their own prices due to the wide discrepancy between self-posted online prices and those they tell potential patients over the phone.
Of the 60 hospitals analyzed, 22 were able to provide prices online and by telephone for vaginal childbirth. Those prices were within 25% of each other at just 10 hospitals. Nine hospitals had internal price differences of 50% or more.
Forty-seven hospitals were able to provide prices online and by telephone for a brain MRI. Those prices were within 25% of each other at 31 hospitals. Twelve hospitals had differences of 50% or more.
Online and telephone prices completely matched in nine hospitals for a brain MRI. For vaginal childbirth, they completely matched at three.
“The findings provide evidence of hospitals’ continuing problems in communicating their own prices to patients. These results illustrate the promise of and substantial barriers to translating newly available hospital price data into actionable information that ultimately facilitates comparison shopping,” researchers wrote in the study.
Price discrepancies could be due to a variety of factors, according to the study.
Hospital billing office staff might not have understood the inquiry, hospitals may not adequately train staff or they might not be aware of a hospital’s online price estimator tool. Researchers also said that potentially the lack of correlation “simply reflects a chaotic and disorganized pricing structure.”
The CMS can fine hospitals up to $2 million for failing to post prices, but there is no formal mechanism for the regulator to audit or penalize hospitals that post incorrect or misleading medical costs.
To date, the CMS has fined 14 hospitals a combined $4.6 million for noncompliance with the price transparency rule.
The Biden administration has faced criticism from Republican lawmakers and some policy experts for not doing enough to enforce reporting requirements on hospitals.
