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2005

Where's the Price Tag? Mystery Shoppers Uncover the Frustration of Shopping for Hospital Care

Report finds consumers need patience, persistence, and ingenuity

December 14, 2005

People who shop for pricing and financial assistance information at California hospitals have a difficult time getting answers, according to a report released today by the California HealthCare Foundation (CHCF). The report, titled Price Check: The Mystery of Hospital Pricing, is available through the link below.

Mystery shoppers posed as uninsured patients requesting pricing information for elective procedures at 64 hospitals in five regions in California. Their experience shows that there is a serious communications gap between hospitals and prospective patients, a gap that has negative implications for the increasing number of patients who pay all or part of their medical bills.

"The mystery shopper study shows much more needs to be done before hospital pricing is transparent to consumers," said Maribeth Shannon, director of the Hospitals and Nursing Homes Program at CHCF. "As patients pay an increasing share of their health care expenses, hospitals must be able to give them information that allows them to comparison shop."

Hospital pricing information is important to the 6.5 million Californians who have no insurance, and the growing number of people who have "consumer-directed health plans," a relatively new type of plan that typically includes high deductibles and requires members to pay more out of pocket before medical expenses are covered.

During the three-month study, mystery shoppers contacted each hospital both in person and by telephone for answers to straightforward questions regarding the price of one of 25 elective procedures or tests, and any financial policies available for those who needed help.

The study found that:

• Obtaining a price depended primarily upon luck and persistence. Experiences varied greatly—even at the same hospital. While 76 percent of the mystery shoppers' overall price inquiries were ultimately answered with a firm or estimated price, more than a third had to make three or more calls to obtain the answer. In fact, one mystery shopper who called the hospital reported 17 points of contact in her search for an answer. Overall, only 32 percent of callers and 25 percent of those who personally visited the hospital were able to obtain the information in one call or visit.
• With few exceptions, the hospitals did not appear to have a designated person or department to provide pricing information. Most hospital staffers seemed unaware of the proper contact person and frequently referred shoppers to other departments.
• When information was provided, there were inconsistencies in the type of prices given. For example, prices could be estimates, firm price quotes, or discounts. Some hospitals gave a range of prices because of the complexity of the procedure or the number of variables involved.
• While most hospitals posted information on financial assistance programs, the information was often hard to find and limited.

The five regions included in the study were Los Angeles; Riverside/San Bernardino; Sacramento/Stockton; San Diego/Orange; and San Francisco Bay Area/San Jose/Oakland. To be part of the sample, a hospital had to have more than 100 beds and be medical and surgical in nature. The sample included for-profit and not-for-profit hospitals and public and private hospitals, as well as children's hospitals.

A list of tips for consumers seeking hospital pricing information, an FAQ about the study, and the full report are available through the link below.

Contact Information

Related CHCF Pages

Price Check: The Mystery of Hospital Pricing