Study Reveals Hospital Price Discrepancies Between Online and Phone Quotes

A recent study has unveiled significant discrepancies in the pricing of medical services between U.S. hospital websites and phone inquiries. This disparity was evident across a selection of 60 U.S. hospitals, focusing specifically on the costs associated with vaginal childbirth and brain MRI procedures. The study, published in JAMA Internal Medicine, disclosed pricing variations that frequently surpassed 50% and, in some instances, even exceeded 100%. Notably, these pricing inconsistencies were prevalent across all types of hospitals, regardless of their rankings or safety-net provider status.

The study’s findings highlight the persistent challenges hospitals face in accurately conveying and comprehending the pricing of specific medical services. These disparities pose considerable hurdles for uninsured patients and individuals striving to make informed healthcare choices.

To conduct their comprehensive research, the investigators assembled a diverse cohort of hospitals, which encompassed 20 top-ranked hospitals, as per U.S. News and World Report’s Honor Roll Hospitals, alongside 20 safety-net hospitals situated near these top-ranked institutions. An additional 20 nearby hospitals that did not fit into either category were included. The researchers meticulously collected pricing data for vaginal childbirth and brain MRI procedures, utilizing Current Procedural Terminology (CPT) codes obtained from each hospital’s publicly accessible website. This data collection spanned from August 2022 to October 2022. Subsequently, they compared these online prices with estimates acquired from secret shoppers posing as hypothetical uninsured patients making phone inquiries.

Observations on Online Pricing Disparities Among Hospital Types

• Study observations highlight pricing disparities among different types of hospitals.
• Vaginal childbirth prices are predominantly available from top-ranked hospitals.
• Brain MRI prices are more common in top-ranked and non-safety-net hospitals.
• Safety-net facilities have fewer accessible brain MRI prices.
• Hospitals providing both online and telephone pricing exhibit discord in pricing information for both services.

A more in-depth analysis of the data uncovered further revelations. Among hospitals providing two available prices for vaginal childbirth, 45% had prices within a 25% range of each other, while 41% exhibited prices differing by more than 50%. Similarly, among hospitals offering two prices for brain MRI scans, 66% displayed prices within a 25% range, but 26% presented prices differing by more than 50%. Astonishingly, certain hospitals displayed online prices exceeding $20,000 for vaginal childbirth while quoting less than $10,000 over the phone. For brain MRI scans, two hospitals provided telephone quotes exceeding $5,000, whereas their online prices hovered around $2,000.

The study uncovered that only 14% of the facilities had matching prices for vaginal childbirth, and a mere 19% exhibited congruent prices for brain MRI scans. This glaring lack of uniformity raises pertinent questions: Do hospitals possess a coherent pricing strategy, or do these disparities simply reflect a disorderly and disorganized pricing framework?

The researchers also observed that obtaining price quotes over the phone was generally more straightforward with top-ranked hospitals, as evidenced by the call duration. However, at some hospitals contacted by phone, a subset of billing staff was unable to provide price estimates, despite their institutions having functional online price estimator tools.

The investigation also laid bare substantial concerns regarding pricing and accessibility. Online prices exhibited wide-ranging discrepancies between hospitals, including glaring errors such as price tags of $0 and almost $167,000 for a brain MRI. These inconsistencies can be, at best, amusing, but at worst, they trigger public frustration and erode trust in the healthcare system.

These challenges in price transparency and accessibility carry profound implications for uninsured or underinsured patients, a demographic that may be growing due to shifts in insurance coverage. The findings also serve as a tangible illustration of how hospitals’ ongoing struggles to adhere to federal price transparency regulations can detrimentally impact healthcare consumers.