Pediatric Price Transparency: Time to Come Out of the Dark.

Abstract

You have a child with a high-deductible insurance plan, or a child who lacks insurance completely, who needs a tonsillectomy and adenoidectomy (T&A). How will you know how much this procedure will cost? Considering that more American children are now covered by high-deductible plans,1 and that there is maddening variation in pricing across hospitals and services,2 the availability of accurate cost and quality data are needed more than ever to ensure that patients obtain the most cost-effective and safe options available. In this issue of Hospital Pediatrics , Wong et al3 are the first to study and review the availability and accessibility of pediatric hospital-based price transparency tools. Their study reveals a difficult and confusing experience for families seeking meaningful cost information from children’s hospitals. Even when one could eventually obtain the requested cost information, the path for doing so was strewn with numerous obstacles: Web sites with unintelligible medical jargon (What parent can decode “Complete CBC w/ auto diff wbc”?), labyrinthine interdepartmental phone transfers, incomplete or inaccurate information, or hospital preregistration requirements before provision of cost estimates. State-based price transparency Web sites reviewed by these researchers did not perform much better. Only 15 (39%) of the Web sites included distinctions between prices for pediatric versus adult care, and most lacked appropriate quality data. With all the clamoring nationally for price transparency, we should not focus solely on the availability of information but should also consider the experience of accessing this information. In this multiphase study, researchers posing as the parent of a 5-year-old, healthy, temporarily-uninsured child attempted to access price data for a needed, but elective, T&A from 45 freestanding children’s hospitals across 25 …