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The Controversy over Price Transparency: Patients and Providers Disagree

Parul Rai, BS1, Priyasha Pareek, BS2, Caitlyn Vilas, BS1 and Jonathan Kaplan, MD, MPH3,4, (1)University of Texas Medical Branch, Galveston, TX, (2)Emory University, Atlanta, GA, (3)Pacific Heights Plastic Surgery, San Francisco, CA, (4)Cleveland Clinic, Cleveland, OH
Goals/Purpose: The No Surprises Act is a new federal policy that requires all providers, including those of self-pay (e.g., aesthetic) services1, to provide a good faith estimate to protect patients from receiving charges exceeding $400 over the original estimate2. Due to the novelty of this policy, this study aimed to understand consumer and provider attitudes towards and experiences with price transparency in healthcare.

Methods/Technique: Two distinct surveys were sent to providers and patients. Providers received a survey asking whether they made pricing available online, reasoning for this choice, and if they believed that the No Surprises Act applies to them. Patients who had previously used an online price estimator tool were also sent a survey unique to their perspective. They were asked about their experience obtaining a price estimate online, the accuracy of the estimate, and how using health insurance influenced their desire to know the cost of healthcare services beforehand. Both patients and providers were asked about their knowledge regarding the No Surprises Act; if they indicated any degree of knowledge about it, they were also asked about their perception of this legislation.

Results/Complications: Most surveyed providers do not share the costs of their services online [Figure 1], and several cited the inaccuracy of online price estimator tools as a reason for not implementing them. Despite having some degree of knowledge regarding the No Surprises Act, many providers believe that this law does not apply to them.

Most patients surveyed expressed having a positive experience with the price estimator tool and endorsed its accuracy. Patients who indicated being aware of the No Surprises Act tended to have a positive perception of the legislation.

Conclusion: Although most providers chose not to make pricing publicly available, the results of this survey suggest that transparency in pricing is patient satisfier, and thus, providers who offer pricing online may attract more patients. Patients who had a positive experience with the price estimator tool indicated that it was because they felt more informed prior to seeking care. Therefore, the decision to implement price transparency can be mutually beneficial, and the healthcare field should consider further reform regarding price transparency practices.

  1. Frequently Asked Questions For Providers About The No Surprises Rules. :11.
  2. No Surprises: Understand your rights against surprise medical bills | CMS. Accessed October 16, 2022. https://www.cms.gov/newsroom/fact-sheets/no-surprises-understand-your-rights-against-surprise-medical-bills

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