Pediatric Price Transparency: Still Opaque With Opportunities for Improvement

Laura J. Faherty, Charlene A. Wong, Jordyn Feingold, Joan Li, Robert Town, Evan Fieldston, Rachel M. Werner

Article Figures & Data

TABLE 1

Price Transparency Information on Children’s Hospital Web Sites (N = 45)

Price Transparency Information	N (%)
Provided price estimate for any pediatric care	8 (18)
Billed charges	6 (13)
Out-of-pocket costs^a	2 (4)
Provided price estimate for tonsillectomy-adenoidectomy	1 (2)
Billed charges	1 (2)
Personalized cost estimation tool available^b	12 (27)
Online form for families to submit	5 (11)
Phone number for families to call for a personalized estimate	9 (20)

Of the 46 freestanding children’s hospitals in the United States, 1 provides oncologic care free of charge to all families and was therefore excluded from the analysis.
↵a Of the 2 hospitals listing out-of-pocket costs, 1 provided mean expected out-of-pocket costs for an insured family (denoted as “typical total patient liability”) with multiple caveats about allowing for individual variation in the amount covered by insurance. The other hospital provided out-of-pocket fees for international adoption clinic services only.
↵b Two of 12 hospitals provided both types of tools.

TABLE 2

Secret Shopper Price Inquires to Children’s Hospitals for a Tonsillectomy-Adenoidectomy (N = 45)

Overall Availability and Characteristics of Price Estimates
Provided price estimate, n (%)	30 (67)
Same-day estimate, n (%)	23 (51)
Price estimate, $, mean (range)
Facility fee only (n = 21)	6266 (1200–12 000)
Facility and professional fees (n = 9)	8071 (3733–15 360)
Specific price estimate phone line inquiry (n = 9)
Provided price estimate, n (%)	9 (100)
Same-day estimate, n (%)	8 (89)
Price estimate, $, mean (range)
Facility fee only (n = 7)	5344 (2622–6400)
Facility and professional fees (n = 2)	8332 (6823–9840)
Call duration in minutes, mean (range)	9 (3–15)
General hospital phone line inquiry (n = 36)
Provided price estimate, n (%)	21 (58)
Same-day estimate, n (%)	15 (42)
Price estimate, $, mean (range)
Facility fee only (n = 14)	6718 (1200–12 000)
Facility and professional fees (n = 7)	7996 (3733–15 360)
Call duration in minutes, mean (range)	8 (2–16)
Online form inquiry (n = 4)^a
Provided price estimate, n (%)	2 (50)
Price estimates, $	4239 and 6823
Time to receipt of estimate in days	1 and 3

↵a One online request form was excluded because it only applied to price estimates for international patients.

TABLE 3

Price Transparency Information on State-Based Price Transparency Web Sites (N = 38)

Price Transparency Information	n (%)
Distinguishes between prices for pediatric and adult care	15 (39)
Age ranges selectable by consumer for all diagnoses	5 (13)
Age specified or “pediatric” flag listed for specific diagnoses	10 (26)
Provided price estimate for tonsillectomy-adenoidectomy	17 (45)
Billed charges	16 (42)
Out-of-pocket costs	1 (3)
Pediatric procedure specified	9 (24)
Price estimate, $, mean (range)^a	9566 (3441–20 287)
Personalized cost estimation tool available,^b	1 (3)
Quality data available	14 (37)

↵a For the site that listed out-of-pocket costs, the estimate obtained was for an uninsured patient.
↵b These tools were customizable, algorithm-based, interactive tools.