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    Need a New Hip? Finding the Cost May Not Be Easy

    By Larry Hand
    Medscape Medical News

    Feb. 11, 2013 -- If you're searching for a new car, a new house, or a new TV, you'll likely compare prices. If you're in the market for a new hip, though, that might not be easy, according to a study published online in JAMA Internal Medicine.

    Even when pricing is available, it can vary widely from hospital to hospital.

    Researcher Jaime Rosenthal, from the University of Iowa Carver College of Medicine, contacted hospitals around the U.S. by telephone. She called two from each state and Washington, D.C., and 20 from the U.S. News & World Report rankings of the best orthopedic hospitals. She then asked them about pricing for a total hip replacement.

    Rosenthal called the hospitals up to five times to get prices for her fictitious 62-year-old grandmother, who had no other health problems and no health insurance, but could pay for the procedure out of pocket.

    She asked for a bundled price, which includes hospital and doctor fees. If only the hospital price was available, she then called an affiliated doctor's office to get the total cost.

    Prices All Over the Place

    Of the 102 hospitals not included in the top-ranked list, Rosenthal was only able to get price estimates from 63%, and only 10% could give the bundled price.

    Of the 20 top-ranked hospitals, 60% provided complete pricing, with 45% of those providing bundled pricing. Fifteen percent provided no pricing.

    Now, the prices: The average for the total cost was similar among the two hospital groups ($53,140 for top-ranked, $41,666 for others). Overall, total prices ranged from more than $11,000 to almost $126,798 in the 64 non-ranked hospitals, and from $12,500 to $105,000 for 12 top-ranked hospitals.

    Hospitals not giving prices cited reasons such as:

    • A patient has to see a doctor first (even though Rosenthal offered an official diagnosis).
    • The hospital does not give prices over the phone.
    • "They had no way to provide such an estimate."

    In a time where health care reform stresses transparency, the researchers write that information on hospital and, to some extent, doctors' care are available from several sources -- yet pricing remains difficult to obtain.

    In an accompanying commentary, Andrew Steinmetz and Ezekiel J. Emanuel, MD, PhD, write, " We are now faced with a health care transparency [need] ... [that] constitutes a presumption that all price and quality data should be publicly available unless there are compelling reasons, such as patient confidentiality, to withhold them."

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