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Finding the Price of Health Care Services Remains Elusive


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"How do we know if the price is right if we can't find out what the price is?" This question was recently posed by CFAH president and founder Jessie Gruman. "These days," she says, "we are exhorted by the media and our employers to act like consumers and 'shop' for our health care even when critical information is rarely available." In other words, it's unfair to advise people to find out the price of a treatment when the price-transparency deck is stacked against them.

Like patients, many doctors are in the dark about how much services cost. A survey released this month of 503 orthopedic surgeons showed that they were "only able to correctly estimate the cost of a device 21 percent of the time...Their guesses ranged from 1.8 percent of the actual price to 24.6 times the actual price." When the cost of something like a knee replacement can vary by thousands of dollars, it can have a huge effect on the person who gets the bill.

Even when consumers are able to determine the cost of their care, they may find prices to be exorbitant. For example, data released by the union group National Nurses United found 14 hospitals were charging patients more than ten times the actual cost of treatment – that's more than a thousand dollars for every one-hundred dollars of the hospitals' total costs. It's well documented that people skip or delay treatments they can't afford, so who will help patients find reliable price information and (hopefully) bring down the cost of care?

Authors Kathryn Phillips, PhD, and Anna Labno wonder if private digital health companies are part of the solution. They looked at five companies that provide health care pricing tools by compiling price information from past health claims. The companies work with self-insured employers and employees access the information via a website. Phillips and Labno conclude: "Price transparency companies do fill an important need by increasing access to prices for services. As they compete among themselves, they might develop more refined pricing tools leading to more engaged patients and informed use of services. The emergence of these companies is a key trend with a potential to alter the health care landscape, but greater transparency and consistency is needed or else there is a risk that customers will become confused and discouraged."

What if most of us are confused and discouraged already?

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Tags for this article:
Health Care Cost   Pay for your Health Care   Inside Healthcare   Health Insurance   Medical/Hospital Practice   Patient Engagement   Health Information Technology  

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