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Comment & Response
February 17, 2015

Goals of Displaying Health Care Prices to Physicians—Reply

Author Affiliations
  • 1Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland
JAMA. 2015;313(7):728-729. doi:10.1001/jama.2014.17451

In Reply We agree with Dr Hoffer that prices are an essential component in assessing value and in general have no objection to the use of price displays. Rather, we argued in our Viewpoint that since different displayed “prices” (eg, hospital list price vs Medicare fee amount) might differentially affect physician behavior, it is important to consider how different prices might operate in practice and weigh the ethical implications of each.

We also agree that patients are arguably the most important stakeholder when assessing value and that physicians should engage with patients in discussing the out-of-pocket costs associated with their care.1 However, in some circumstances, robust shared decision making may not be possible. For example, patients in acute care hospitals or intensive care units may be unable or uninterested in weighing cost trade-offs. In a recent survey of hospitalized patients, more than 70% indicated that they preferred to leave medical decision making to their physician.2

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