Journal Highlights
JAMA Ophthalmology, November 2021
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The Hospital Price Transparency rule, which requires hospitals to publish online their pricing information for all services and payers, went into effect on Jan. 1, 2021. Berkowitz et al. evaluated the availability, usability, and variability of standard reported prices for two common cataract procedures at academic hospitals. They found substantial noncompliance with the rule, suggesting that most patients were still unable to find the information they need on current standard charges.
For this economic evaluation, the researchers assessed 247 academic hospitals. (Veterans Affairs facilities, children’s hospitals, and large multihospital networks were not included in this analysis.) Of these, 238 provided machine-readable files of standard charges, and 191 provided consumer-friendly price estimators or online tools.
A routine search engine query was used to emulate an average consumer’s approach to finding pricing information. If available, the gross charge, discounted cash price, and de-identified minimum and maximum prices were documented for CPT codes 66821 (Discission of secondary membranous cataract) and 66984 (Extracapsular cataract removal with insertion of intraocular lens prothesis). Specific components of each price (e.g., hospital, physician, anesthesiologist, supplies) were recorded, if available. In addition, consumer-friendly metrics—such as how long it typically took to get an answer to a query—were recorded.
Only 29 hospitals (15.2%) provided full pricing data. The majority of hospitals (155; 81.2%) provided a gross charge for CPT code 66984, with 102 hospitals (53.4%) also providing cash pricing for this procedure. The prices for CPT code 66821 were less frequently available, with 101 hospitals (52.9%) and 71 institutions (37.2%) providing gross and cash price information, respectively. In addition, the amounts quoted varied 27-fold among hospitals for CPT code 66821 and 51-fold for CPT code 66984.
Finally, usability issues were noted for 36 hospitals (18.8%); these included requirements for personal information and web page navigability barriers.
Given these problems, the researchers said, a centralized database and additional legislation may be necessary. In particular, they noted, uninsured patients who need to compare cash pricing between institutions need genuine pricing transparency. (Also see related commentary by Michael X. Repka, MD, MBA, in the same issue.)
The original article can be found here.