Data Brief | No. 112 | January 2022

Maine Residents Worry about High Hospital Costs; Have Difficulty Estimating Quality/Cost of Care; and Express Bipartisan Support for Government Action

While hospitals are important healthcare providers and vital members of our communities, a poll of Maine residents, conducted from Oct. 18, 2021 to Oct. 28, 2021, finds that many worry about hospital costs and support government-led solutions across party lines.  

Hardship and Worry about Hospital Costs

A substantial portion of Maine residents worry about affording healthcare costs in the future and many report experiencing financial hardship due to hospital costs. Nearly two-thirds (65%) report being either “worried” or “very worried” about affording the medical costs from a serious illness or accident. Maine residents may have cause to worry about affording hospital care—of the 27% who report receiving an unexpected (a.k.a surprise) medical bill in the past year, 2 in 5 (41%) report that at least one such bill came from a hospital. 

Skills Navigating Hospital Care

Maine residents report high confidence in their ability to know when to seek emergency care, with 3 in 5 (64%) reporting that they are very or extremely confident about knowing when to go to the emergency department versus a primary care provider. However, Maine adults are less confident in their ability to find hospital cost and quality information. Fifty-four percent of residents have low confidence in their ability to find out the cost of a hospital procedure ahead of time, and 54% have low confidence in their ability to find quality ratings for hospitals.

Maine adults’ lack of confidence may reflect the fact that those who have tried to find information about hospitals have not always been successful. Forty-three percent of survey respondents report that they have tried to find quality information on hospitals, but just 30% of those who sought such information actually found the information they were looking for. Similarly, 37% of respondents have tried to find the cost of a hospital stay ahead of time, but only 23% were successful. 

Low confidence in residents’ ability to find price and quality information, combined with their limited success, may indicate that this type of information is not easily accessible, despite Maine’s price transparency tool (CompareMaine), which displays some quality data and median total costs for certain procedures at different facilities.^1,2 Lack of knowledge of hospital quality and potential costs impede Maine residents’ ability to plan for needed care and budget for the expense of a hospital stay, which can be costly,³ particularly for residents who are un- or under-insured.  

Support for “Fixes” across Party Lines

Hospitals, along with drug manufacturers and insurance companies, are viewed as a primary contributor to high healthcare costs. When given more than 20 options, those that Maine adults most frequently cited as being a “major reason” for high healthcare costs were:

• 75%–Drug companies charging too much money  
• 70%–Hospitals charging too much money  
• 65%–Insurance companies charging too much money 

Maine adults strongly endorse a number of hospital-related strategies, including:

• 90%–Require hospitals and doctors to provide up-front cost estimates to consumers⁴
• 89%–Set standard payment to hospitals for specific procedures
• 84%–Set up an independent entity to rate doctor and hospital quality, such as patient outcomes and bedside manner
• 63%–Pay doctors and hospitals a fixed monthly fee per patient, instead of payment for each service

What’s even more interesting is the level of support for some of these strategies across party lines (see Table 1).

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Conclusion

The findings from this poll suggest that Maine residents are motivated when it comes to searching for hospital cost and quality information to help inform purchasing decisions and plan for a future medical expense. However, cost and quality information are difficult for Maine adults to find, despite recent action at the federal level to make hospital prices more transparent.⁵

It is not surprising that Maine residents express strong support for government-led solutions to make price and quality information more readily accessible and to help patients navigate hospital care. Many of the solutions respondents’ support would take the burden of research and guesswork off of consumers’ shoulders, by standardizing payments for specific hospital procedures, requiring hospitals and doctors to provide consumers with cost estimates for certain procedures or establishing an entity to conduct independent quality reviews, among other solutions. Policymakers should investigate the evidence on these and other policy options in order to respond to Maine adults’ bipartisan call for government action. 

For survey methodology and full report, please see Maine Residents Struggle to Afford High Healthcare Costs; COVID Fears Add to Support for a Range of Government Solutions Across Party Lines, Healthcare Value Hub, Data Brief No. 111 (January 2022). 

Notes

1. For information on users’ experience with CompareMaine, see: https://altarum.org/sites/default/files/uploaded-publication-files/Consumer-Centric-Transparency_Final_0805.pdf

2. As of January 1, 2021, the Centers for Medicare and Medicaid Services (CMS) requires hospitals to make public a machine-readable file containing a list of standard charges for all items and services provided by the hospital, as well as a consumer-friendly display of at least 300 shoppable services that a patient can schedule in advance. For more information, see: https://www.cms.gov/hospital-price-transparency/hospitals

3. According to Health Forum, an affiliate of the American Hospital Association, hospital adjusted expenses per inpatient day in Maine were $2,581 in 2019–just below the national average. See: Kaiser Family Foundation, State Health Facts Data: Hospital Adjusted Expenses per Inpatient Day. Accessed May 27, 2021.  

4. See Footnote 2. 

5. This survey was conducted after the Centers for Medicare and Medicaid Services’ rule requiring hospitals to publicly display all standard charges for all items and services, as well as shoppable services, in a consumer-friendly format went into effect. While survey respondents may be reflecting on their experiences before the rule went into effect, the well-documented low compliance from large hospitals indicates that the rule has yet to demonstrate the desired effect. See: Kurani, Nisha, et al., Early Results from Federal Price Transparency Rule Show Difficulty in Estimating the Cost of Care, Kaiser Family Foundation, (April 9, 2021). See also: Henderson, Morgan, and Morgane C. Mouslim, “Low Compliance from Big Hospitals on CMS’s Hospital Price Transparency Rule,” Health Affairs Blog (March 16, 2021).