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Rural For-Profit Hospitals Are Associated With Higher Commercial Prices for 3 Common Urological Procedures.

Ian Berger1, Alexandria Spellman1, Vishnukamal Golla1,2,3

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Urological surgery prices are significantly higher at rural for-profit hospitals compared to nonprofit facilities. This price disparity may limit access to affordable care for underinsured rural patients.

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Area of Science:

  • Urology
  • Health Economics
  • Healthcare Policy

Background:

  • Rural populations face limited access to specialized urological services.
  • High costs of urological procedures can be a barrier for underinsured individuals in rural areas.
  • Understanding price variations is crucial for addressing healthcare access disparities.

Purpose of the Study:

  • To compare the commercially insured prices of three common urological procedures across different hospital types (rural vs. metropolitan, for-profit vs. nonprofit).
  • To identify factors associated with price differences in urological care.
  • To inform strategies for improving affordable urological care access.

Main Methods:

  • Cross-sectional analysis of commercially insured prices from the Turquoise Health Transparency data set.
  • Inclusion of ureteroscopy with laser lithotripsy, transurethral resection of bladder tumor, and transurethral resection of prostate.
  • Linking hospital characteristics using Centers for Medicare and Medicaid Services data and employing linear modeling to analyze price associations.

Main Results:

  • Median prices for all three procedures were substantially higher at rural for-profit hospitals compared to rural nonprofit and metropolitan for-profit hospitals.
  • Rural for-profit status was independently associated with significantly higher prices for ureteroscopy (160%), transurethral resection of bladder tumor (50%), and transurethral resection of prostate (113%).
  • A total of 1,532 hospitals reported urological prices in the dataset.

Conclusions:

  • Rural for-profit hospitals charge more for common urological surgeries than other hospital types.
  • These price differentials may exacerbate healthcare access issues for underinsured rural residents.
  • Interventions promoting patient transportation and price transparency could enhance access to affordable urological care.