TRANSPARENCY OF PUBLICLY AVAILABLE ART CHARGES ON U.S. CLINIC WEBSITES

Abstract

Background: Treatment for ART services is relatively expensive and encourages patients to compare charges among ART clinics. There continues to be increased demand for ART services. Along with these, one would expect increased online searches of ART treatments and corresponding charges. This study evaluated the transparency and informativeness of ART-associated charges publicly available on ART clinic websites across the U.S. Study design: Evaluation of U.S. ART clinic websites was performed by three raters using a true/false rating scale to determine the availability of the ART- associated charges, including diagnosis, treatment, monitoring, medications, and laboratory services. We evaluated whether academic and non-academic medical centers, geographic location, clinic volume, or ART-mandated and non-mandated coverage for infertility treatment influence the transparency of ART charges. Interrater variability was assessed using modified Fleiss' kappa. Chi-Square analysis was used to test whether DHHS regions, academic versus non-academic hospitals, ART-mandated states versus non-mandated states, and the area's urban character influence the charges displayed. The role of the annual number of total ART cycles on ratings was assessed using the Pearson correlation. Results: Of the 464 ART clinics evaluated, 84% (n=390) were classified as minimally transparent and informative regarding publicly available ART charges. Of DHHS-designated regions, Region 8 (Denver) had the highest transparency (57.1%, p<0.001) for information on fresh ART cycles. There were no differences among the remaining nine DHHS regions. The ART state mandate, academic affiliation, population density, urbanization level, and clinical volume were not associated with greater transparency of ART charges. Conclusion: Many ART clinics demonstrate minimal transparency and informativeness of their charges on clinic websites. Analysis of the DHHS regions, ART-mandated states, the role of academia, population density, and level of urbanization suggests that the lack of transparency could be associated with current ART clinic-specific policies.