Breast Reconstruction Prices Remain Difficult for Patients to Find Online
Study finds many Texas hospitals did not clearly publish costs despite a federal transparency law

Patients considering breast reconstruction often struggle to find clear hospital prices online, even though federal rules require hospitals to post them, suggests a study in the June issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).

"Access to price information is limited, with wide variance across procedures and insurers, greatly impairing patients' ability to make informed healthcare decisions," comments lead author Steven L. Henry, MD, of the University of Texas Dell Medical School.

Meaningful information lacking

Researchers reviewed 32 large Texas hospitals and found that only 18 posted any online pricing for breast reconstruction procedures. Even when prices were posted, the information often appeared in formats that were difficult for patients to find, open or understand.

"This is a complaint that patients have frequently, that the cost of reconstruction is completely obscured," says Dr. Henry. "Even when they ask for the cost, the hospital doesn't give it to them."

That lack of clarity for patients can add financial uncertainty to an already stressful medical decision for patients considering breast reconstruction.

Self-pay patients face the greatest uncertainty

The problem was especially serious for patients paying out of pocket. Self-pay prices were often not listed at all. When they were listed, they could vary widely.

"That's ironic, isn't it?" Dr. Henry says. "Those are the people who would be inclined to shop the most vigorously to find pricing answers."

Posted prices often fail to provide clarity

The study also found that some hospitals posted pricing files in formats that were not practical for patients to use, including enormous spreadsheets or file types that many people could not open.

"It would either be a spreadsheet that you might be able to read, but that would have a million rows," Dr. Henry says. "Or it would be in some format that you wouldn't have the ability to open on your computer. ... Completely useless formatting was common."

Prices may not reflect the full cost

The listed hospital prices also did not always show patients what the full procedure would cost. Hospital fees may not include surgeon fees, anesthesia, lab work or other services. That means even patients who find a posted price may still not know the total amount of what they will actually owe.

The authors suggest better enforcement of the law, more standardized reporting and easier-to-read formats could help patients compare options and make more informed decisions. The findings show that currently, real price transparency for breast reconstruction remains more promise than reality.

Plastic and Reconstructive Surgery® is published by Wolters Kluwer.

Click here to read "Hospital Price Transparency Legislation and Published Costs of Breast Reconstruction in Texas"

Article: "Hospital Price Transparency Legislation and Published Costs of Breast Reconstruction in Texas" (doi: 10.1097/PRS.0000000000012559)