Private Payer-Negotiated Prices for Outpatient Otolaryngologic Surgery.

Annette A Wang, Roy Xiao, Rosh K V Sethi, Vinay K Rathi, George A Scangas
Author Information
  1. Annette A Wang: Harvard Medical School, Boston, Massachusetts, USA.
  2. Roy Xiao: Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, Massachusetts, USA. ORCID
  3. Rosh K V Sethi: Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA.
  4. Vinay K Rathi: Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, Massachusetts, USA.
  5. George A Scangas: Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, Massachusetts, USA.

Abstract

In January 2021, the Centers for Medicare & Medicaid Services began requiring hospitals to publish price transparency files listing all prices negotiated with payers. We performed a cross-sectional analysis of payer-negotiated prices for commonly performed Outpatient otolaryngology surgery at all hospitals scored by the in otolaryngology. We compared prices among hospitals (across-center ratios) and among payers at the same hospital (within-center ratios). Price disclosure rates were low overall for otolaryngologic surgery (maximum, 26.7% for bronchoscopy). Across-center ratios ranged from 3.5 (adjacent tissue transfer/rearrangement <10 cm; raw median price range, $1384-$7047) to 18.6 (cochlear implant placement; raw median price range, $2417-$60,255). Median within-center ratios ranged between 2.7 (intraoperative navigation) and 5.4 (total thyroidectomy). Although price variation may signal opportunities for cost savings, patients may have limited ability to comparison shop due to hospital nondisclosure. Further investigation is necessary to examine the factors affecting price variation for otolaryngologic procedures.

Keywords

MeSH Term

Aged
Cost Savings
Cross-Sectional Studies
Humans
Medicare
Outpatients
United States

Word Cloud

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