New findings from an analysis of hospital price transparency have been published recently in JAMA. The analysis was carried out by a team from Brigham and Women's Hospital and Massachusetts Eye and Ear following the introduction of a new requirement from The Centers for Medicare and Medicaid Services (CMS) that mandates that hospitals list their prices for services and items online. Despite this new requirement being a step in the right direction toward improving price transparency, the researchers’ analysis shows that it is not being regularly enforced.
"Reporting payer-negotiated prices is an important first step toward helping patients estimate the cost of care before receiving treatment," said corresponding author Roy Xiao, MD, MS, a resident in Otolaryngology-Head and Neck Surgery at the Brigham and Mass Eye and Ear. "Based on previous work, we expected to see some degree of variation, but the full range that we saw in our study was certainly surprising."
The study focused specifically on the price transparency and price variation for the treatment of thyroid cancer, which is known to be hugely expensive. Thyroid cancer patients boast the highest rates of bankruptcy among all cancer patients. The team’s analysis showed that only half of the cancer centers they looked at reported disclosing of payer-negotiated prices. Meanwhile, they also found a huge variation in prices between cancer care centers.
For example, between centers, they observed a 70-fold difference in the cost of radioactive iodine treatment and a 44-fold difference in the cost of neck computed tomography. They also saw a broad variation of prices even within the same center depending upon a patient’s health insurance.
Now, while this doesn’t necessarily shine a good light on hospitals and cancer care centers, the researchers say that it is important to take into account that they did their analysis soon after the introduction of the new requirement, meaning hospitals are still figuring out how to efficiently comply with the new rule. They have hope that disclosure rates and transparency will increase in the near future.
"Centers are facing a new reality when it comes to price transparency -- never before have they been required to make these rates available, and it's a huge lift to collect this information and make it available in a way that is intelligible to patients," said co-first author Vinay Rathi, MD, MBA, a resident in Otolaryngology-Head and Neck Surgery at the Brigham and Mass Eye and Ear. "As this information becomes available, we're interested in exploring how it can be used to help our patients."