Approach Price Transparency with Caution, AAFP President Says

Meeting Americans' expectations for price transparency in physician, hospital and pharmacy charges "is a good idea but must be done very cautiously," according to AAFP President Larry Fields, M.D., of Ashland, Ky.

Fields' comments came in response to results of a Zogby International poll (PDF file: 2 pages / 30.6 KB. More about PDFs.) recently released by the Council for Affordable Health Insurance. According to the poll, 84 percent of 1,209 respondents agreed that physicians, hospitals and pharmacies should publish prices for all of their goods and services. The poll also reported that 79 percent of respondents said they would be likely to shop around for the best price if such information were available.

"Americans are used to seeing prices on just about everything they buy -- except health care," said Merrill Mathews Jr., Ph.D., director of the council, in a May 1 news release announcing the poll results. "It's hard to see why health care should be any different."

But health care is different from other commodities, because the final price of an office visit often depends on the results of the history and physical examination, said Fields. Although some prices, such as the charge for a basic office visit or an immunization, can be posted, a physician can't always predict the final cost of an acute care visit because additional lab work may be required to ensure an accurate diagnosis.

"A simple click of the mouse on the computer or a price list on the wall would be less than informative," said Fields. "It could lead to problems with expectations not being met on price."

Fields took that message to the White House in February, when he joined other health care leaders in a meeting with Allan Hubbard, the president's assistant for economic policy and director of the National Economic Council.

Fields followed the February meeting with a letter to Hubbard that further explained the process through which prices are determined. Physicians can post the price for CPT codes, Fields said in the letter; but neither the patient nor the physician can know in advance which code will actually be charged because "the final charge is dependent upon the degree of history and physical examination required by the patient's condition, the intensity of the medical decision-making and appropriate tests ordered."