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Descriptions and Changes in Charge Master Pricings of US Children's Hospitals From 2019 to 2021
Raymond Parlar-Chun1, Katelin Samaniego2, Adam Jagen2
1Department of Pediatrics.
Insights
Healthcare price transparency remains a challenge, with significant price variations for common tests in children's hospitals. Even after mandates, costs for services like chest X-rays increased, highlighting ongoing price inconsistencies.
Area of Science:
- Health Economics
- Healthcare Policy
- Medical Economics
Background:
- The lack of price transparency in healthcare contributes to escalating costs.
- US hospitals were mandated to publish their charge masters online starting in 2019.
- This study examines price changes for common medical tests in children's hospitals post-mandate.
Purpose of the Study:
- To compare the charge master prices of three common tests between 2019 and 2021.
- To analyze price variations in US children's hospitals following the online charge master mandate.
- To assess the impact of price transparency on healthcare costs.
Main Methods:
- Conducted online searches for hospital charge masters in 2019 and 2021.
- Collected price data for complete blood count, complete metabolic panel, and chest radiograph.
- Adjusted prices for inflation and used paired t-tests for year-over-year comparisons.
- Evaluated city-level price variation using the coefficient of variation in six major metropolitan areas.
Main Results:
- Charge masters were accessible for 86% of hospitals in 2019 and 88% in 2021.
- Prices for complete blood count and complete metabolic panel showed no significant change between the two years.
- Chest radiograph prices significantly increased from 2019 to 2021 ($365 to $392, P < .0006).
- Significant price variability persisted across hospitals and within metropolitan areas.
Conclusions:
- Two years post-mandate, substantial price disparities for common tests persist in US children's hospitals.
- The online charge master mandate has not yet resolved significant price variability.
- Further efforts are needed to improve healthcare price transparency and reduce cost inconsistencies.
Background And Objectives:
A lack of price transparency may contribute to high healthcare costs. US hospitals were mandated to post their charge masters online in 2019. To compare changes in charge master prices of 3 common tests (complete blood count, complete metabolic panel, and chest radiograph) at US children's hospitals between 2019 and 2021.
Methods:
Online search for charge master was conducted from July to December 2019 and October to December 2021. Descriptive statistics were reported for each test. Prices between years were adjusted for inflation and compared with paired t test. City-level variation was evaluated by comparing the coefficient of variation in 6 metropolitan areas: Baltimore, California Bay Area, Chicago, Dallas-Fort Worth, Los Angeles, and New York City.
Results:
Of 847 hospitals, charge masters were found in 747 (88%) in 2021 and 728 (86%) in 2019. Complete blood count prices ranged from $5 to $1037 in 2019 and $5 to $1085 in 2021, with no difference between the 2 years (P = .17). Complete metabolic panel prices ranged from $10 to $2440 in 2019 and $6 to $2746 in 2021, with no difference in prices (P = .75). Chest radiograph prices ranged from $20 to $1900 in 2019 compared with $30 to $5800 in 2021. Prices were higher compared with 2019 ($392 vs. $365, P < .0006). City-level changes in the coefficient of variation showed only 2 cities with reduced coefficients of variation in all 3 tests.
Conclusions:
Two years after mandating hospitals post charge masters online, there continues to be tremendous variability in prices of common tests across US children's hospitals.
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