Outpatient radiology providers missing the mark when communicating costs to patients

Outpatient radiology providers appear to be missing the mark when communicating cost-related information to patients, according to new research.

It was about three years ago that the Centers for Medicare & Medicaid Services implemented price transparency mandates for hospital services. University California, Irvine, was among those heeding the call, creating an estimator tool to help inform individuals undergoing imaging at one of its four affiliated outpatient centers.

However, uptake appears low, with less than 11% of radiology outpatients even aware of their out-of-pocket costs, experts detailed Aug. 19 in the journal of Health Policy and Technology [1]. Out of 423 patients surveyed, only 17% knew of the imaging centers’ price estimator tool and none of them had used it.

Radiologist Gelareh Sadigh, MD, and colleagues believe their findings demonstrate the importance of educating consumers about costs, which could potentially improve uptake and collections.

“Our results emphasize the need for targeted interventions aimed at improving patient understanding of [out-of-pocket costs] and awareness of price estimator tools,” Sadigh, with the Department of Radiological Sciences at UCI, and co-authors concluded. “As healthcare systems strive for greater transparency, addressing the identified barriers is a crucial step toward ensuring informed decision-making and minimizing the financial burden for patients undergoing imaging.”

For the study, researchers electronically surveyed adult patients who speak English, Spanish or Vietnamese and had received an outpatient CT, PET/CT or MRI exam between late 2022 or early 2023. Respondents were an average age of 57 and 57% female. About 55% were white, 22% Hispanic and 19% Asian. Having a household income of $50,000 or higher and having at least one comorbidity were associated with a higher probability of knowing out-of-pocket costs prior to imaging. Conversely, those who experienced financial hardship were less likely to be aware of OOPC. No significant factors were associated with awareness of the hospital price estimator tool, the authors noted.

Sadigh and co-authors speculated that patients with higher incomes have greater health insurance literacy, enabling them to know where to look for cost information before receiving a bill. While those facing financial hardship were more worried about costs, the lack of awareness may have been due to poor insurance literacy and financial self-efficacy. Patients with comorbidities likely had greater knowledge about OOPC because of their more frequent use of healthcare services, Sadigh et al. wrote.

To improve patient familiarity, the authors suggested interventions such as educational videos. Policymakers also could allocate resources to public awareness campaigns or partnerships with community organizations to reach a wider audience. They also suggested building greater understanding on how to use patient portals and where to find price estimators tools. UCI experts believe there is a need to develop standardized formats for presenting price information, ensuring websites are user-friendly and consistent across different providers.

“Further, enhancing the radiology staff's (e.g., scheduler or front-desk) awareness of price estimator tools would enhance communication about it with the patient,” the authors advised. “Lastly, there was a gap between awareness of the price estimator tool (16.8%) vs. the utilization of the tool (0%) in the current study. To address this gap, systems should be in place to notify all patients about their OOPC prior to receipt of service whether in terms of portal messages or automated calls to remove the need for the patient to navigate the tool on their own.”