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Price estimates for routine medical procedures prove elusive, study finds

Researchers investigated routine procedure, endured long wait times, dropped calls, and incomplete information, study shows.

Jeff Lagasse, Associate Editor

Price estimates for routine medical procedures are difficult, often prohibitively so, to come by for consumers in major metropolitan areas, despite price transparency provisions in the Affordable Care Act and in many individual states. That's the word from two expert researchers from the Pioneer Institute.

The research was conducted by Barbara Anthony, a lawyer and senior fellow in healthcare at the Pioneer Institute, and Scott Haller, a senior at Northeastern University pursuing a degree in political science. Their study focuses on six regions: Des Moines, Iowa, Raleigh-Durham, North Carolina, Orlando, Florida, Dallas-Fort Worth, Texas, Los Angeles, California and New York City.

"Healthcare price transparency is more important than ever before because of the growth of high-deductible health plans among non-subsidized middle-income consumers," wrote Anthony and Haller in their findings. "The Commonwealth Fund's Healthcare Affordability Index for 2015 reported that, across the country, 43 percent of adults with moderate incomes -- almost $47,000 for an individual and $95,400 for a family of four -- said their deductible was difficult or impossible to afford...

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This exposure to large out-of-pocket expenses means that the price of many procedures and office visits has a direct effect on consumers."

Research subjects asked for the price of an MRI for their left knee, and in 57 percent of the hospitals studied, it took more than 15 minutes to get a complete price, including the radiologist's fee for reading the MRI. Two-thirds of the time, researchers had to call a separate number or organization to obtain an estimate for the reading.

[Also: Experian Health and St. Clair Hospital unveil patient estimate tool amid drive towards transparency]

Of 54 hospitals studied, 40 gave information that was complete. Price estimates for the MRIs ranged wildly -- from $400 at Huntington Hospital in Los Angeles, to $4,544 at New York City's Montefiore Medical Center.

Fourteen of the hospitals did not provide complete price estimates.

Anthony and Haller said in their study that many of the employees at the hospitals examined weren't sure what to do with price requests. The researchers say they called multiple times, and endured long wait periods and a number of dropped calls. Price information on their respective websites was scant.

[Also: Intermountain revenue cycle VP: Hospitals are on the hook for price transparency]

The researchers suggested that hospitals should better train staff to handle price requests, and that information should be more readily available on their respective websites. They also called for more education for patients about the importance of price transparency.

"When healthcare prices are hidden or unavailable, consumers cannot make informed decisions," they wrote. "While some studies claim that consumers don't want to know the price of healthcare and are not interested in comparing prices, the fact is that consumers have never had access to price transparency. When they do try to get price information, it is, for the most part, impracticable to obtain. Transparency allows ordinary consumers to find out the price of medical procedures before they obtain services, and can help consumers better manage and control their healthcare spending."

Twitter: @JELagasse