Hospitals report different prices online and telephonically

October 6, 2023

JAMA Internal Medicine published sobering data on hospital transparency last month. Researchers looked on websites and inquired by telephone for prices for two services, vaginal childbirth and brain MRI scans at 60 hospitals. For each procedure, they asked for the price of a single billing code. They found a poor correlation between prices found on the web and those quoted by phone. These were a mix of top-ranked and safety net hospitals and hospitals that fit into neither of these categories.

The headline on this study is that many hospitals showed one price online, and a different price when queried by telephone. The researchers can’t say whether either of these price quotes reflected what the hospital ultimately bills!

I also paid attention to just how hard it was to get prices out of hospitals, over a year after the hospital transparency regulations went into effect. Over a third of top-ranked hospitals and almost 4 in 5 “other” hospitals could not say what they would bill for a facility fee for vaginal childbirth. Half of safety net hospitals couldn’t provide both telephonic and online reporting for the cost of brain MRIs!

Source: Thomas, et al JAMA Int Med, September 18, 2023 LINK

Implications for employers: 

• This study illustrates how difficult it is for patients to find accurate prices.

• Employers should be skeptical of claims that transparency will allow members to “shop” and therefore lower prices. Many services are not “shoppable,” and those who represent a large portion of total medical expenses often are beyond their out-of-pocket maximum.

• Health plan transparency requirements include providing machine readable files to third parties, so hopefully we will have better insight into correct prices at hospitals in the coming years.

Monday: Women pay $15 billion a year more than men in out-of-pocket costs

Thanks for reading.  You can find previous posts in the Employer Coverage archive

Please “like” and suggest this newsletter to friends and colleagues.

Have a great weekend, and thanks!