By Lisa Rapaport


Reuters Health – Consumers who search online for prices of common medical procedures may be disappointed by what they find, a U.S. study suggests.

Researchers used the search engines Google and Bing to check the cost of common services like cholesterol tests, hip replacements and magnetic resonance imaging (MRI) scans in 8 cities: New York; Los Angeles; Chicago; Seattle; Baltimore, Maryland; Charlotte, North Carolina; Manchester, New Hampshire; and Tallahassee, Florida.

They did a simple search, such as “cost of hip replacement in Los Angeles,” swapping in different medical services and cities each time, to see how often the results would lead consumers to a price.

Of 1,346 websites in the search results that weren’t advertisements, only 234, or 17 percent, provided geographically relevant price information, the study found.

“Our findings suggest that there is substantial room for improvement in providing consumers with ready access to health care prices online,” Dr. Peter Ubel of Duke University in Durham, North Carolina, and colleagues write in JAMA Internal Medicine.

The lack of price transparency online persists at a time when a growing number of consumers are turning to the Internet to make decisions about their health. It also comes at a time when many consumers are either uninsured or have medical benefits with high deductibles that require them to pay steep out-of-pocket fees for their care.

Among the websites that turned up in the search results, only 295, or 22 percent, were designed to explain pricing for a specific medical intervention, the study found.

Another 382 websites belonged to single providers or clinics, while 63 gave information on quality without any details on pricing, the study also found.

Roughly 17 percent of the websites, or 234, didn’t offer any information that appeared related to pricing or health costs at all.

The availability of online price information also appeared to vary by region.

In Chicago, about 27 percent of the websites offered locally relevant price information, while only 7 percent of websites did this for Baltimore.

It’s possible that some websites with online pricing information didn’t show up in the researchers’ search results, if the managers of those sites didn’t use so-called search optimization tools, the authors note.

Most websites didn’t specify whether any costs displayed were the consumer’s out-of-pocket fees. For example, prices for cholesterol testing in Chicago ranged from $25 to $100, brain MRIs ranged from $230 to $1,950, and hip replacements went from $27,000 to $80,671.

“Unfortunately, while pricing information online can give one a rough estimate of the variation in pricing and higher versus lower pricing at different centers, they usually do not give an accurate estimate of actual costs,” said Dr. Nilay Kumar, a researcher at the University of Wisconsin School of Medicine and Public Health in Madison who wasn’t involved in the study.

“Patients should directly check with their insurers and providers regarding pricing for services,” Kumar said by email.

Cost isn’t necessarily going to be the main factor driving patients’ decisions about health care, said Dr. Karandeep Singh, a researcher at the University of Michigan in Ann Arbor who wasn’t involved in the study. Often, patients will decide where to go for care based on which providers are in-network with their insurance, and this might not always include the highest-quality or most affordable providers, Singh said.

“Unfortunately, cost information continues to remain a black box,” Singh said by email.


SOURCE: JAMA Internal Medicine, online December 4, 2017


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