Families appreciate cost transparency


The cost of hospitalization can be very expensive for families and cost transparency is not common. What do parents want?

The cost of health care in the United States can often be expensive. Worries about that cost may lead to skipping care or struggling to pay bills, with a recent survey in Massachusetts finding that half of those surveyed had an affordability burden. One way to tackle this problem has been the call for transparency in hospital costs, which often lead to the most expensive medical bills. However, this clarity in expenses has remained elusive for many. A report investigates whether parents want to have cost transparency when their child requires care and what experiences they may have with it.1

Investigators performed a cross-sectional multicenter survey study that included 6 geographically diverse US children’s hospitals that were affiliated with universities. The sample included English- and Spanish-speaking parents who had hospitalized child that was nearing hospitalized children. In addition to demographic information, the survey asked questions in 3 different categories: health care costs, which included questions like “did you talk about the costs of your child’s tests and treatments with a hospital employee;” the child’s health insurance status, which had questions like “how much is your child’s deductible each year;” and the family’s financial situation, which included questions like “how often do you worry about being able to meet normal monthly living expenses.”

A total of 526 parents completed the survey. Most parents said that knowing the cost of care was important to them and 397 of the parents indicated that they believe that an employee at the hospital should discuss the costs of care. However, just 36 parents reported that they had a conversation about costs. When asked who they would want to have cost discussions with, 294 parents stated a preference of having them with financial counselors. Nearly 1 in 5 parents worried that having a discussion would negatively impact the quality of care that their child received. Forty-nine percent of the parents said that clinicians should consider parental costs when making medical decisions. Families that had medical bill difficulties unrelated to the hospitalized child were found to have a higher mean agreement that family costs should be taken into consideration with medical decision-making than those families with no medical financial burdens (effect size, 0.55 [95% CI, 0.18-0.92]).

The investigators concluded that overall, parents would welcome a chance to discuss the costs of care for their child during an acute hospitalization. Unfortunately, those discussions are relatively rare, meaning an important way to engage and provide support to families is frequently not done.


1. Bassett H, Beck J, Coller R, et al. Parent preferences for transparency of their child’s hospitalization costs. JAMA Netw Open. 2021;4(9):e2126083. doi:10.1001/jamanetworkopen.2021.26083

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