[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words
    1 Comment for this article
    Try FAIR Health?
    Marco D. Huesch | USC Sol Price School of Public Policy; Duke University School of Medicine and Duke Fuqua School of Business
    I agree with the authors that price transparency is important and wanted to point out one good source of independent price estimates.

    I just used FAIR Health's consumer cost look-up website (fairhealthconsumer.org) to see what the professional fees for a total hip arthroplasty might end up costing an uninsured patient. The information from this independent, non-profit organization resulting from NY AG Andrew Cuomo's settlement with commercial insurers is not binding and does not include hospital facility charges. But I found that the 80th centile of professional medical fee undiscounted pricing is $6,840 near where I am in downtown Los
    Angeles (zipcodes 900XX), $11,999 nearer to Beverly Hills (902XX), and $9,640 around Stanford (943XX). That fits well with the authors' data in Table 3. Consumers are limited to 20 searches a month, but this may be a good, initial way to explore options at a coarse level for uninsured patients.

    CONFLICT OF INTEREST: I received payments for consulting services to the IOM's Committee on Geographic Variation. No other relevant financial interests or potential conflicts
    Original Investigation
    Health Care Reform
    Mar 25, 2013

    Availability of Consumer Prices From US Hospitals for a Common Surgical Procedure

    Author Affiliations

    Author Affiliations: Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City (Mss Rosenthal and Lu, and Dr Cram); and The Center for Comprehensive Access and Delivery Research and Evaluation (CADRE), Iowa City Veterans Administration Medical Center, Iowa City (Ms Lu and Dr Cram). Ms Rosenthal is a student at Washington University, St Louis, Missouri.

    JAMA Intern Med. 2013;173(6):427-432. doi:10.1001/jamainternmed.2013.460

    Importance Many proposals for health care reform incentivize patients to play a more active role in selecting health care providers on the basis of quality and price. While data on quality are increasingly available, availability of pricing data is uncertain.

    Objective To examine whether we could obtain pricing data for a common elective surgical procedure, total hip arthroplasty (THA).

    Design We randomly selected 2 hospitals from each state (plus Washington, DC) that perform THA, as well as the 20 top-ranked orthopedic hospitals according to US News and World Report rankings. We contacted each hospital by telephone between May 2011 and July 2012. Using a standardized script, we requested from each hospital the lowest complete “bundled price” (hospital plus physician fees) for an elective THA that was required by one of the author's 62-year-old grandmother. In our scenario, the grandmother did not have insurance but had the means to pay out of pocket. We explained that we were seeking the lowest complete price for the procedure. When we encountered hospitals that could provide the hospital fee only, we contacted a random hospital affiliated orthopedic surgery practice to obtain the physician fee. Each hospital was contacted up to 5 times in efforts to obtain pricing information.

    Setting/Participants All top-ranked and a sample of non–top-ranked US hospitals performing THA.

    Main Outcome Measures Percentage of hospitals able to provide a complete price estimate for THA (physician and hospital fee) for top-ranked and non–top-ranked hospitals and range of prices quoted by each group.

    Results Nine top-ranked hospitals (45%) and 10 non–top-ranked hospitals (10%) were able to provide a complete bundled price (P < .001). We were able to obtain a complete price estimate from an additional 3 top-ranked hospitals (15%) and 54 non–top-ranked hospitals (53%) (P = .002) by contacting the hospital and physician separately. The range of complete prices was wide for both top-ranked ($12 500-$105 000) and non–top-ranked hospitals ($11 100-$125 798).

    Conclusions and Relevance We found it difficult to obtain price information for THA and observed wide variation in the prices that were quoted. Many health care providers cannot provide reasonable price estimates. Patients seeking elective THA may find considerable price savings through comparison shopping.