title: Availability of consumer prices for bunion surgery.
abstract: BACKGROUND
  Today, insurance insulates most patients from the true costs of the health care services they consume. Economists believe that the absence of price signals incentivizes patients to pursue more extensive care than they would otherwise. Reformers propose restoring price consciousness to patients as a way to tame the soaring costs of American health care. To test this idea, we decided to gauge the availability and variability of price quotes for a common elective surgery-bunion repair.
  
  
  METHODS
  Orthopedic clinics were sorted by state and randomly selected from an online directory maintained by the American Orthopaedic Foot and Ankle Society. Each selected clinic was contacted up to 3 times in an attempt to get a full, bundled price quote using a standardized patient script. If this was unavailable, an isolated quote for the physician fee alone was solicited.
  
  
  RESULTS
  Of the 141 clinics contacted, 56 (39.7%) could provide a physician price estimate and 12 (8.5%) could give a complete bundled estimate, including hospital fees. The overall mean bundled price quoted was $18 332, while the overall mean physician fee quoted was $2487. There was no statistically significant difference in the mean price quoted by academic and private clinics, nor was regional variation observed.
  
  
  CONCLUSIONS
  We found low price availability for elective bunion procedures.
  
  
  CONCLUSIONS
  However, the wide variation observed in the prices that were quoted suggests that a very determined patient may be able to spend substantially less on an elective surgery if they were willing to select a provider carefully.
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, IA, USA.
authors.forename: James C
authors.initials: JC
authors.lastname: Willey
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, IA, USA.
authors.forename: Lainee S
authors.initials: LS
authors.lastname: Reuter
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, IA, USA daniel-belatti@uiowa.edu.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Belatti
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, IA, USA.
authors.forename: Phinit
authors.initials: P
authors.lastname: Phisitkul
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, IA, USA.
authors.forename: Ned
authors.initials: N
authors.lastname: Amendola
mesh_terms: D003365:Costs and Cost Analysis; D017558:Elective Surgical Procedures / Q000191:economics / Q000379:methods; D018588:Fee-for-Service Plans / Q000191:economics* / Q000639:trends; D005260:Female; D006215:Hallux Valgus / Q000191:economics* / Q000601:surgery*; D017048:Health Care Costs; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000191:economics; D017722:Hospital Charges / Q000639:trends*; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000191:economics*; D020380:Needs Assessment; D009985:Orthopedics / Q000191:economics; D010027:Osteotomy / Q000191:economics* / Q000379:methods; D012955:Societies, Medical; D014481:United States; D055815:Young Adult
keywords: bunion; foot and ankle surgery; hallux valgus; price availability; price transparency; price variability