Surgical procedures cost significantly more at hospitals in networks versus independent facilities, study finds
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Dive Brief:
- Prices for surgical procedures are significantly higher at healthcare facilities within networks than at independent hospitals, according to research published Monday in JAMA Network Open.
- The median price for a shoulder arthroscopy was $4,432 at hospitals within a network, compared to $2,643 at independent hospitals, the study found.
- Procedures also had major variations in negotiated prices across facilities, the study found. At hospitals within a network, the median price for a knee cartilage removal procedure was $1,446 higher than at independent hospitals. And the median price for a prostatectomy at facilities in hospital networks was $966 more than at independent hospitals.
Dive Insight:
The findings come as hospitals have remained noncompliant with federal price transparency rules requiring providers to publicly post prices for healthcare services to help patients shop around for care and boost competition.
Out of 2,000 U.S. hospital’s websites, only about 25% were in full compliance with the rules, according to a recent analysis from PatientRightsAdvocate.org.
Some major chains like HCA Healthcare, Tenet, Providence and UPMC lacked any compliant hospitals in that analysis.
Researchers in the JAMA Network Open study analyzed 3,195 hospitals’ negotiated prices through the Turquoise Health Database, which aggregates price data published by hospitals under the price transparency rule.
For 15 of the 16 surgical procedures hospitals are required to post, median negotiated prices were significantly higher at hospitals within networks than at independent hospitals, the study found.
It’s still unclear exactly how negotiated rates differ across hospitals within networks compared to independent ones, the study’s authors wrote.
Hospitals within networks may have greater market share, allowing them to negotiate higher rates with payers, though being part of a larger network may also allow for scale leading to lower prices, according to the study.
“As more hospitals become compliant with this policy, it will be important to better understand the mechanisms behind these significant variations in negotiated prices for surgical care to identify areas of unwarranted variation that may be mitigated,” they wrote.
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