Association between price transparency and patient decision to complete outpatient imaging

Ali Rashidi; Thao Pham; Aldo Arce; Diya Garg; Gelareh Sadigh

doi:10.1016/j.clinimag.2024.110397

Association between price transparency and patient decision to complete outpatient imaging

Clin Imaging. 2024 Dec 27:119:110397. doi: 10.1016/j.clinimag.2024.110397. Online ahead of print.

Authors

Ali Rashidi¹, Thao Pham², Aldo Arce², Diya Garg², Gelareh Sadigh³

Affiliations

¹ Department of Radiological Sciences, University of California Irvine, Irvine, CA, USA; Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA.
² Department of Radiological Sciences, University of California Irvine, Irvine, CA, USA.
³ Department of Radiological Sciences, University of California Irvine, Irvine, CA, USA. Electronic address: [email protected].

PMID: 39736182
DOI: 10.1016/j.clinimag.2024.110397

Abstract

Purpose: The impact of price transparency on patients' decisions to receive the recommended care is unclear. This study aimed to assess the utilization rate of hospital price estimator tools for outpatient imaging appointments, and the association between price estimator utilization and subsequent imaging completion.

Methods: In this retrospective, cross-sectional study, adult patients with scheduled outpatient radiology examinations between August 2022 and 2023 at a single tertiary academic health system were included. Data regarding whether an out-of-pocket cost (OOPC) estimate was generated for the scheduled imaging exam, the estimate generation date, amount, generator (patient vs. staff), the date of first view by patients, appointment status (completed vs. missed appointment), and demographics were extracted. The association between price estimator use and imaging completion was assessed using generalized estimation equation multivariable regression models.

Results: A total of 470,422 imaging encounters (mean age: 55.6 ± 19.1; 57.5 % female; 56.3 % white) were included. Overall, 70,437 (15.0 %) OOPC estimates were generated (99.9 % by hospital staff and 0.1 % by patients). There was a higher number of self-pay patients among those with self-generated (55.8 %) vs. staff-generated (8.9 %) estimates (P < 0.001). The odds of imaging appointment completion were significantly higher when an OOPC estimate was generated (OR,1.91; 95 % CI, 1.87, 1.95), and significantly lower when the estimate was self-generated (OR,0.29; 95%CI, 0.17, 0.51).

Conclusion: Price-aware patients with staff-generated cost estimates were more likely to complete imaging. Self-pay patients were more likely to self-generate estimates, which was associated with lower likelihood of completing imaging.