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Hospital Prices for Pediatric Tympanostomy Tube Placement and Adenotonsillectomy in 2021
Ashley L Miller1,2, Roy Xiao3,4, Vinay K Rathi3,4
1Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Insights
Hospital prices for pediatric surgeries like myringotomy with tympanostomy tube placement (M&T) and adenotonsillectomy (T&A) vary widely. Many hospitals fail to disclose prices, and those that do show significant price differences between and within facilities.
Area of Science:
- Health economics and policy
- Pediatric healthcare access
- Medical billing and transparency
Background:
- Substantial price variations exist for common pediatric surgical procedures, including myringotomy with tympanostomy tube placement (M&T) and adenotonsillectomy (T&A).
- The Centers for Medicare and Medicaid Services mandated hospital price transparency to aid families in making informed financial decisions regarding healthcare.
Purpose of the Study:
- To assess the availability of published hospital prices for M&T and T&A procedures.
- To quantify the extent of price variation for these procedures across and within healthcare institutions.
Main Methods:
- A cross-sectional analysis was conducted using the Turquoise Health Hospital Rates Data Platform.
- Data on facility fees were extracted from publicly available hospital chargemasters.
- The study focused on hospitals serving pediatric patients, examining payer-specific prices for M&T and T&A.
Main Results:
- Only 40% of hospitals serving pediatric patients disclosed prices for M&T or T&A.
- Among disclosing hospitals, price variation was substantial: across-center ratios ranged from 11.0 for M&T to 23.4 for revision adenoidectomy.
- Median within-center price ratios ranged from 2.2 to 2.7, indicating significant price discrepancies for the same procedure within a single hospital.
Conclusions:
- A majority of hospitals failed to comply with federal price disclosure requirements for M&T and T&A.
- Significant payer-specific price variations exist both between and within hospitals for these pediatric procedures.
- Further research is needed to determine if price transparency effectively empowers families to make financially sound healthcare choices.
Objectives:
Hospital prices vary substantially for myringotomy with tympanostomy tube placement (M&T) and adenotonsillectomy (T&A). The Centers for Medicare and Medicaid Services recently implemented hospital price transparency requirements to help families make financially informed decisions about where to seek care. We sought to determine price availability and the extent of price variation for these procedures.
Methods:
We performed a cross-sectional analysis of the Turquoise Health Hospital Rates Data Platform, which extracts prices for facility fees from publicly available hospital chargemasters. We determined the proportion of hospitals serving pediatric patients that published payer-specific prices for M&T and T&A. We additionally characterized the extent of variation in payer-specific prices both across and within hospitals.
Results:
Approximately 40% (n = 909 of 2,266 hospitals) serving pediatric patients disclosed prices for M&T or T&A. Among disclosing hospitals, across-center ratios (adjusted for Medicare hospital wage indices) ranged from 11.0 (M&T; 10th percentile adjusted median price: $536.80 versus 90th percentile adjusted median price: $5,929.93) to 23.4 (revision adenoidectomy age >12 years; 10th percentile: $393.82 versus 90th percentile: $9,209.88). Median within-center price ratios for procedures ranged from 2.2 to 2.7, indicating that some private payers reimbursed the same hospital more than twice as much as other payers for the same procedure.
Conclusion:
The majority of hospitals serving pediatric patients were non-compliant with federal requirements to disclose prices for M&T and T&A. Among disclosing hospitals, there was wide variation in payer-specific prices between and within institutions. Further research is necessary to understand whether disclosure of prices will enable families to make more financially informed decisions.
Level Of Evidence:
3 Laryngoscope, 133:948-955, 2023.
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