LAUSR

INTRODUCTION January 1, 2021, the Centers for Medicare and Medicaid Services (CMS) implemented a Hospital Price Transparency Rule. Consumerism as a means of reducing healthcare expenditures is predicated on informed consumers making discrete choices. METHODS For 10 months, immediately following an academic medical center preoperative clinic visit, patients and their surgeons were surveyed regarding their estimation of hospital cost and hospital reimbursement for the upcoming surgery. Responses were compared to average FY 2019 institutional Cost for Medicare patients undergoing a laparoscopic approach for each operation. We calculated the difference between actual reimbursements and costs with patients' estimates and actual reimbursements and costs with surgeons' estimates. RESULTS 66 questionnaires were collected from patients who underwent laparoscopic: cholecystectomy (n=20), inguinal hernia (n=17), umbilical hernia repair (n=6), ventral hernia repair (n=6), incisional hernia (n=6), hiatal hernia repair (n=1), and lipoma or cyst excision (n=10). Patients' estimates for hospital costs exceeded actual hospital costs by a median of $4502 and were less than hospital reimbursements by a median of $1834. Surgeon estimates for direct costs were $825 less than hospital direct costs and $1659 less than hospital reimbursement. CONCLUSION Patients as well as their surgeons do not estimate healthcare costs or remuneration accurately and therefore will be ineffective change agents in reducing surgical spending based on price transparency without further education of both parties. Patients consistently overestimated surgical costs while surgeons consistently underestimated surgical costs and reimbursements. Better-informed surgeons and patients are likely necessary prerequisites for CMS Price Transparency Rules to be effective in reducing Medicare expenditures in surgery.