Does price transparency legislation allow the uninsured to shop for care?

Journal of General Internal Medicine
Kate Stockwell FarrellAteev Mehrotra

Abstract

The majority of states have enacted price transparency laws to allow patients to shop for care and to prevent price discrimination of the uninsured. In California, hospitals must provide a price estimate to a requesting uninsured patient and cannot bill for an amount greater than the reimbursement the hospital would receive from a government payer. To assess the response rate of California hospitals to a patient price request and to compare the price estimates received to Medicare reimbursement. We sent letters to California acute-care hospitals from a fictional uninsured patient requesting an estimate for one of three common elective procedures: a laparoscopic cholecystectomy, a hysterectomy, or routine screening colonoscopy. Three hundred and fifty-three hospitals in California. Hospital response rates, difference between price estimates received, and Medicare reimbursement for equivalent procedures. Only 28% (98/353) of hospitals responded and their response varied in content. Of the 98 responses, 15 (15%) did not provide a quote and instead asked for more information such as the billing code, 55 (56%) provided a price estimate for hospital services only, 10 (10%) included both physician and hospital services, and 18 (18%) d...Continue Reading

Citations

Jun 4, 2014·Annals of Emergency Medicine·Renee Y Hsia, Yaa Akosa Antwi
Jan 1, 2012·Inquiry : a Journal of Medical Care Organization, Provision and Financing·Kelly A Kyanko, Susan H Busch
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