New case study shows patients who shop around could save thousands in hospital bills

Media Contacts
Maribeth Guarino

Former High Value Health Care, Advocate, U.S. PIRG Education Fund

ED NOTE: Since the release of the report, we have fixed an error and have changed the press release below. If you have any questions, please contact Mark Morgenstein at [email protected]

CLEVELAND – The Centers for Medicare and Medicaid Services (CMS) requires U.S. hospitals to post their prices in a “consumer-friendly” format so patients get upfront information about possible health care costs. U.S. PIRG Education Fund’s new case study, Post the price: Hospital price transparency could save patients thousands, is a microcosm of what patients are dealing with across the United States. Researchers investigated how patients in the Cleveland area could find these prices and comparison shop to save money. The study found a difference of more than $200,000 between the highest and lowest cash prices for total knee replacement surgery, just in one major city. 

“Strong price transparency is important to empower patients across the nation to make informed decisions when it comes to their health care spending. Patients need to know that they can now see their prices and potentially save thousands of dollars on their care,” said Maribeth Guarino, U.S. PIRG Education Fund’s health care advocate. “Most people take price into account when shopping for expensive things, from appliances to college educations. You know how much those things cost up front. Americans should know that health care costs no longer should be a mystery either. Hospitals are required to post prices for more than 300 procedures.

The listed cash prices for knee replacement ranged from around $26,000 to more than $240,000. For the insurance plan selected for the case study, the price range was much lower — $5,900-$9,100 — because of its specific deductible and limits on out-of-pocket costs. But that’s still a large variance; a $3,200 difference could be a game-changer for patients deciding where to have their surgery.

Finding those prices wasn’t always easy. We surveyed 27 hospitals and found prices for total knee replacement at 20 of them. One hospital does not offer this surgery. We could not find prices for the procedure at six Cleveland Clinic locations, although we were able to confirm that they offered the procedure. Hospitals with information missing from their websites don’t comply with federal rules. 

“We need better enforcement of transparency rules because patients deserve to know how much their care will cost before they receive it,” Guarino said. “We shouldn’t have to jump through hoops to discover a price that hospitals are required to provide.”

To go along with the report, U.S. PIRG Education Fund has created an online consumer guide to teach patients how to find the prices they’re looking for.