My Summer Internship: Unveiling the Truth Behind Hospital Price Transparency

This summer I worked for PIRG on our healthcare campaigns encompassing affordable healthcare, price transparency, and surprise ambulance billings. As a Public Health major and Business minor at UT Austin, I already knew my passion for understanding the opportunities and challenges within the healthcare system. I chased the chance to be immersed in work that would have a positive and direct impact on healthcare consumers and patients. I didn’t know exactly what I’d be working on until my first day when I quickly found out I’d be diving into the world of hospital price transparency.

Hospital price transparency is vital to prospective patients who are seeking an  affordable and cost-effective facility for their procedure. There’s a rule in place hospitals are required to post their self-pay as well as their insured prices for the 300 most common procedures. Specifically, I analyzed the price estimator tools for a significant number of Dallas hospitals for a Total Knee Arthroplasty (CPT code 27447). I did this to better understand hospital price transparency in the Dallas market. The end result is a report we released today called Acute Confusion: Why it’s so hard for patients to compare hospital prices.

I’ve been asked frequently by friends and family this summer “What are you doing for your internship?” I’ve been proud to detail my PIRG project, searching hospital websites for their price transparency pages, researching the rules and regulations around hospitals posting their prices, working with hospital representatives to obtain apples to apples pricing, and the struggles and complexities I’ve endured as well as the knowledge I’ve gained from this experience. Honestly, before this summer I had never used a hospital procedure estimator tool, and I’ve realized so many don’t even know the comparative information is available like it is. And, through this process, I’ve realized just how critical it is to know the information is out there, how to access it, and then how to use it.

Research and Analysis Process

When I started the research process, one of the first things I did was narrow down the number of hospitals for which I’d analyze prices. It was shocking to see all the specialty hospitals, surgical centers, ERs, and primary care offices spanning the Dallas metro area. Targeting hospitals offering reconstructive knee surgery, I began to use their estimator tools to capture prices for both the self-paying and the insured. There were nine different hospital systems we analyzed with 19 hospital locations in total. Some hospital systems’ tools were straightforward, making it easy to analyze and gather information. For those, I was usually able to receive a price right away for both the self-pay and the insured options.  

Challenges and Findings

In contrast, for others, it would take multiple attempts, sorting through red tape, and many calls to get self-pay information, or an insured price. Through these calls, I experienced long hold times, multiple transfers trying to find the right person to talk to, leaving messages with no call back, and one hospital representative acknowledging to me that she didn’t even believe their price estimator tools are even accurate. And, the hospitals with transparency issues weren’t always the ones you’d imagine. A very highly ranked hospital per a U.S. News and World Report, wouldn’t provide me with an insured price until the surgery “was scheduled.” Isn’t that like agreeing to buy a car without first knowing the price? It made me wonder if the hospital rankings systems consider price transparency in their evaluations. Otherwise, how would a hospital with such a subpar price estimator tool be ranked so high in an official and reputable news ranking? 

This whole process, although it’s supposed to help patients, can be hard for individuals who aren’t familiar with “the system.” After time I got the hang of it, but I can understand how gathering prices, speaking to hospital representatives, figuring out one’s own insurance coverage, and trying to organize the information can be daunting for a prospective patient.

My Reflections

Through this internship, researching and speaking to experts in the field of price transparency and healthcare, I have a much deeper and greater appreciation for the value of price transparency within the healthcare system. But just as important as the public availability of this information, is the accuracy. It’s imperative for hospitals to provide accurate prices for patients in a clear and concise manner. Being aware of these tools and understanding their value could save a patient $10k if they drive five miles down the road. I believe there needs to be more awareness about this comparative information, especially amongst the younger population who are entering the real world and learning about adulting including understanding their healthcare options and insurance policies.  

In conclusion, my summer internship this year was unlike anything I’d ever expected or thought I’d be doing this summer. I’m immensely grateful for this experience as I learned the positive effects of price transparency when done well, and the negative effects and financial burdens for patients and their families when it is not.