Transparency, Repricing, and Price Convergence in Cancer Care

Cancer imposes a significant economic burden on the US healthcare system and its patients. We quantified changes in price levels and variation for oncologic services after federal price transparency regulations and evaluated whether the prevalence and granularity of disclosures were associated with these changes.

This retrospective longitudinal study used nationwide hospital price transparency data from December 2021 to June 2024. The data set included billing codes across 4 oncology service categories (inpatient, chemotherapy administration, radiation, and surgery). A linear mixed-effects model evaluated the annualized real rate change (ARRC) as a function of local market-specific percentile price rank, transparency measures, service category, payer, market structure, and health system.

Data were extracted for 89 billing codes from 228 hospitals, yielding 11 290 negotiated rate groups and 349 990 monthly observations. Each 10-percentage-point increase in code-level transparency was associated with a 0.82-percentage-point decrease in ARRC (P < .001). Within local markets, hospitals in initially low- or high-price deciles demonstrated inflation-adjusted price increases and decreases, respectively, with a -21.2 percentage point ARRC differential between the lowest and highest rates (P < .001). Price changes and convergence varied by service category, payer, and hospital size (P < .05). Price dispersion declined over time (P < .01).

After federal price transparency regulations, markets with greater code-level transparency experienced larger price reductions, and prices converged as variation between high- and low-priced hospitals declined. These findings suggest transparency may promote more efficient and affordable cancer care, although the overall impact on spending and access remains uncertain.