PDF(Pubmed)
Abstract：
BACKGROUND: Increasing health care expenditure in the United States has put policy makers under enormous pressure to find ways to curtail costs. Starting January 1, 2021, hospitals operating in the United States were mandated to publish transparent, accessible pricing information online about the items and services in a consumer-friendly format within comprehensive machine-readable files on their websites.
OBJECTIVE: The aims of this study are to analyze the available files on hospitals\' websites, answering the question-is price transparency (PT) information as provided usable for patients or for machines?-and to provide a solution.
METHODS: We analyzed 39 main hospitals in Florida that have published machine-readable files on their website, including commercial carriers. We created an Excel (Microsoft) file that included those 39 hospitals along with the 4 most popular services-Current Procedural Terminology (CPT) 45380, 29827, and 70553 and Diagnosis-Related Group (DRG) 807-for the 4 most popular commercial carriers (Health Maintenance Organization [HMO] or Preferred Provider Organization [PPO] plans)-Aetna, Florida Blue, Cigna, and UnitedHealthcare. We conducted an A/B test using 67 MTurkers (randomly selected from US residents), investigating the level of awareness about PT legislation and the usability of available files. We also suggested format standardization, such as master field names using schema integration, to make machine-readable files consistent and usable for machines.
RESULTS: The poor usability and inconsistent formats of the current PT information yielded no evidence of its usefulness for patients or its quality for machines. This indicates that the information does not meet the requirements for being consumer-friendly or machine readable as mandated by legislation. Based on the responses to the first part of the experiment (PT awareness), it was evident that participants need to be made aware of the PT legislation. However, they believe it is important to know the service price before receiving it. Based on the responses to the second part of the experiment (human usability of PT information), the average number of correct responses was not equal between the 2 groups, that is, the treatment group (mean 1.23, SD 1.30) found more correct answers than the control group (mean 2.76, SD 0.58; t65=6.46; P<.001; d=1.52).
CONCLUSIONS: Consistent machine-readable files across all health systems facilitate the development of tools for estimating customer out-of-pocket costs, aligning with the PT rule\'s main objective-providing patients with valuable information and reducing health care expenditures.
OBJECTIVE: The aims of this study are to analyze the available files on hospitals\' websites, answering the question-is price transparency (PT) information as provided usable for patients or for machines?-and to provide a solution.
METHODS: We analyzed 39 main hospitals in Florida that have published machine-readable files on their website, including commercial carriers. We created an Excel (Microsoft) file that included those 39 hospitals along with the 4 most popular services-Current Procedural Terminology (CPT) 45380, 29827, and 70553 and Diagnosis-Related Group (DRG) 807-for the 4 most popular commercial carriers (Health Maintenance Organization [HMO] or Preferred Provider Organization [PPO] plans)-Aetna, Florida Blue, Cigna, and UnitedHealthcare. We conducted an A/B test using 67 MTurkers (randomly selected from US residents), investigating the level of awareness about PT legislation and the usability of available files. We also suggested format standardization, such as master field names using schema integration, to make machine-readable files consistent and usable for machines.
RESULTS: The poor usability and inconsistent formats of the current PT information yielded no evidence of its usefulness for patients or its quality for machines. This indicates that the information does not meet the requirements for being consumer-friendly or machine readable as mandated by legislation. Based on the responses to the first part of the experiment (PT awareness), it was evident that participants need to be made aware of the PT legislation. However, they believe it is important to know the service price before receiving it. Based on the responses to the second part of the experiment (human usability of PT information), the average number of correct responses was not equal between the 2 groups, that is, the treatment group (mean 1.23, SD 1.30) found more correct answers than the control group (mean 2.76, SD 0.58; t65=6.46; P<.001; d=1.52).
CONCLUSIONS: Consistent machine-readable files across all health systems facilitate the development of tools for estimating customer out-of-pocket costs, aligning with the PT rule\'s main objective-providing patients with valuable information and reducing health care expenditures.
摘要：
背景：美国医疗保健支出的增加使政策制定者承受着巨大的压力，要求他们找到削减成本的方法。从1月1日开始,2021年，在美国运营的医院被要求发布透明的，在其网站上的全面的机器可读文件中，以消费者友好的格式在线访问有关商品和服务的定价信息。医院系统发布的内容是否可用？
目的：要分析医院网站上可用的文件，回答问题：提供的价格透明度信息是否可用于患者或机器？并提供解决方案。
方法：我们分析了佛罗里达州的39家主要医院，这些医院在其网站上发布了机器可读文件，包括商业运营商。我们为四个最受欢迎的商业运营商（HMO/PPO计划）-Aetna创建了一个Excel文件，其中包括39家医院以及四个最受欢迎的服务-CPT45380、29827、70553和DRG807，FL蓝色,Cigna,和联合医疗保健。我们使用67名MTurkers（从美国居民中随机选择）进行了A/B测试，调查对价格透明度立法的认识水平和可用文件的可用性。我们还建议格式标准化，例如使用模式集成的主字段名称使机器可读文件一致并可用于机器。
结果：当前价格透明度信息的可用性差和格式不一致，没有证据表明其对患者有用或对机器的质量。这表明该信息不符合法规规定的对消费者友好或机器可读的要求。根据对实验第一部分(价格透明度意识)的回应，显然，与会者需要了解价格透明度立法。然而,他们认为在收到服务之前知道服务价格很重要。基于对实验第二部分(价格透明度信息的人类可用性)的回应，两组之间正确回答的平均数量不相等，即，治疗组（M=1.23，SD=1.30）比对照组（M=2.76，SD=0.58）发现更多的正确答案，t(65)=6.46,P<.05,d=1.52。
结论：在所有卫生系统中使用一致的机器可读文件有助于开发用于估算客户自付费用的工具，与价格透明度规则的主要目标保持一致：为患者提供有价值的信息并减少医疗保健支出。
背景：本研究遵循南佛罗里达大学机构审查委员会批准的方案进行（研究编号：STUDY004145）。
目的：要分析医院网站上可用的文件，回答问题：提供的价格透明度信息是否可用于患者或机器？并提供解决方案。
方法：我们分析了佛罗里达州的39家主要医院，这些医院在其网站上发布了机器可读文件，包括商业运营商。我们为四个最受欢迎的商业运营商（HMO/PPO计划）-Aetna创建了一个Excel文件，其中包括39家医院以及四个最受欢迎的服务-CPT45380、29827、70553和DRG807，FL蓝色,Cigna,和联合医疗保健。我们使用67名MTurkers（从美国居民中随机选择）进行了A/B测试，调查对价格透明度立法的认识水平和可用文件的可用性。我们还建议格式标准化，例如使用模式集成的主字段名称使机器可读文件一致并可用于机器。
结果：当前价格透明度信息的可用性差和格式不一致，没有证据表明其对患者有用或对机器的质量。这表明该信息不符合法规规定的对消费者友好或机器可读的要求。根据对实验第一部分(价格透明度意识)的回应，显然，与会者需要了解价格透明度立法。然而,他们认为在收到服务之前知道服务价格很重要。基于对实验第二部分(价格透明度信息的人类可用性)的回应，两组之间正确回答的平均数量不相等，即，治疗组（M=1.23，SD=1.30）比对照组（M=2.76，SD=0.58）发现更多的正确答案，t(65)=6.46,P<.05,d=1.52。
结论：在所有卫生系统中使用一致的机器可读文件有助于开发用于估算客户自付费用的工具，与价格透明度规则的主要目标保持一致：为患者提供有价值的信息并减少医疗保健支出。
背景：本研究遵循南佛罗里达大学机构审查委员会批准的方案进行（研究编号：STUDY004145）。
