A Nationwide Study on Price Transparency and Variables Affecting the Cost of Common Hand Procedures

Area of Science:

• Health Economics
• Health Services Research
• Orthopedic Surgery

Background:

• The Centers for Medicare and Medicaid Services (CMS) mandated hospital price transparency in 2021 to empower patients and reduce healthcare costs.
• Understanding hospital compliance and price variation is crucial for evaluating the law's effectiveness.

Purpose of the Study:

• To assess hospital compliance with price reporting regulations.
• To analyze price variations for common hand surgery procedures.
• To identify hospital-specific factors influencing procedure pricing.

Main Methods:

• Utilized the Turquoise Health database to extract contracted rates for 14 common hand surgery CPT codes from 3,700 hospitals (March-August 2023).
• Collected detailed hospital information, including ownership, location, and safety net status.
• Performed univariate and multivariable analyses to determine the impact of hospital characteristics on pricing.

Main Results:

• Analyzed 769,349 contracted rates, revealing significant price variation across hospitals for hand surgery procedures.
• Dupuytren disease treatment exhibited the widest price range, while lesion excision showed the least variation.
• Geographic region (Northwest, West), private ownership, and non-safety net status were associated with higher prices.
• Hospital ratings, academic status, bed size, and price transparency compliance did not consistently affect prices.

Conclusions:

• Despite CMS price transparency legislation, substantial variation in pricing and transparency persists for common hand surgeries.
• This lack of consistent price transparency may hinder informed patient decision-making, especially for elective procedures.
• Further investigation into the drivers of price variation and patient impact is warranted.