A study co-authored by billionaire entrepreneur Mark Cuban found significant discrepancies in price estimates for hospital services, depending on how patients sought them.
The study, published this week in JAMA Internal Medicine, compared online cash price estimates for vaginal childbirth and brain MRI services with estimates obtained via "secret shopper" calls. The study looked at 60 hospitals grouped as top-ranked, safety net or neither. It was co-authored by affiliates of educational institutions such as Baylor College of Medicine and the University of Texas Medical Branch, plus Cuban, co-founder of Mark Cuban Cost Plus Drug Company and a big proponent for affordable and transparent drug pricing.
Price transparency in healthcare has become a hot-button topic as costs continue to rise. Federal legislators passed the No Surprises Act in 2020, seeking to protect patients from unexpected out-of-network bills. As of 2021, hospitals were also required to post prices for services in a machine-readable format and provide a cost estimator tool for patients as part of the Hospital Price Transparency Rule.
Many hospitals, however, are still not in compliance with the transparency rule, often citing administrative burdens.
Of the 60 hospitals in the study, 22 provided online and phone price estimates for vaginal childbirth. Among those, only three hospitals provided matching estimates. Ten hospitals provided estimates within 25% of each other, and nine hospitals provided estimates that differed by 50% or more, according to the study.
For brain MRIs, 31 of the 47 hospitals offering online and phone estimates provided quotes within 25% of each other, while 12 hospitals gave estimates that differed by at least 50%. Nine hospitals provided matching prices, the study found.
Prices obtained via phone could be higher or lower than those listed online, said Dr. Peter Cram, one of the study's co-authors and a professor at the University of Texas Medical Branch.
"They don't know their own prices, or it suggests that they don't actually have a single true price," Cram said. "I think that people should be a bit taken aback by that."
The study also found prices varied widely between hospitals. For example, online prices for vaginal childbirth at top-ranked facilities ranged from $0 to $55,221, and prices at safety-net hospitals ranged from $4,361 to $14,377.
"People should shop around," Cram said. "For most patients in most markets, there's a less expensive hospital that is truly delivering reasonable quality, and people should be thinking about the price of the services that they're getting, not just about which hospital is down the street or which one their doctor recommends."