Making Meaningful Use of Price Transparency Data: Describing Price Variation of Spine Surgery and Imaging in a Single System.

Autor:	Olufawo MO; Center for Innovation in Neuroscience and Technology, Washington University in Saint Louis School of Medicine, St. Louis, Missouri, USA.; Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA.; Olin Business School at Washington University in Saint Louis, St. Louis, Missouri, USA., Evans SS; Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA.; Olin Business School at Washington University in Saint Louis, St. Louis, Missouri, USA., Stecher PT; Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA.; Olin Business School at Washington University in Saint Louis, St. Louis, Missouri, USA., Youkilis SL; Olin Business School at Washington University in Saint Louis, St. Louis, Missouri, USA., Dibble CF; Department of Neurological Surgery, Washington University in Saint Louis School of Medicine, St. Louis, Missouri, USA., Greenberg JK; Department of Neurological Surgery, Washington University in Saint Louis School of Medicine, St. Louis, Missouri, USA., Ray WZ; Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA.; Department of Neurological Surgery, Washington University in Saint Louis School of Medicine, St. Louis, Missouri, USA.; Division of Neurotechnology, Washington University in Saint Louis School of Medicine, St. Louis, Missouri, USA., Hamilton BH; Olin Business School at Washington University in Saint Louis, St. Louis, Missouri, USA., Leuthardt EC; Center for Innovation in Neuroscience and Technology, Washington University in Saint Louis School of Medicine, St. Louis, Missouri, USA.; Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA.; Department of Neurological Surgery, Washington University in Saint Louis School of Medicine, St. Louis, Missouri, USA.; Division of Neurotechnology, Washington University in Saint Louis School of Medicine, St. Louis, Missouri, USA.; Brain Laser Center, Washington University in Saint Louis School of Medicine, St. Louis, Missouri, USA.
Jazyk:	angličtina
Zdroj:	Neurosurgery [Neurosurgery] 2022 Sep 01; Vol. 91 (3), pp. e88-e94. Date of Electronic Publication: 2022 Jun 23.
DOI:	10.1227/neu.0000000000002062
Abstrakt:	Price transparency is an increasingly popular solution for high healthcare expenditures in the United States, but little is known about its potential to facilitate patient price shopping. Our objective was to analyze interhospital and interpayer price variability in spine surgery and spine imaging using newly public payer-specific negotiated charges (PNCs). We selected a subset of billing codes for spine surgery and spine imaging at 12 hospitals within a Saint Louis metropolitan area healthcare system. We then compared PNCs for these procedures and tested for significant differences in interhospital and interinsurer IQR using the Mann-Whitney U Test. We found significantly greater IQRs of PNCs as a factor of the insurance plan than as a factor of the hospital for cervical spinal fusions (interinsurer IQR $8256; interhospital IQR $533; P < .0001), noncervical spinal fusions (interinsurer IQR $28 423; interhospital IQR $5512; P < .001), computed tomographies of the lower spine (interinsurer IQR $595; interhospital IQR $113; P < .0001), and MRIs lower spinal canal (interinsurer IQR $1010; interhospital IQR $158; P < .0001). There was no significant difference between the interinsurer IQR and the interhospital IQR for lower spine x-rays (interinsurer IQR $107; interhospital IQR $67; P = .0543). Despite some between-hospital heterogeneity, we show significantly higher price variability between insurers than between hospitals. Our single system analysis limits our ability to generalize, but our results suggest that savings depend more on hospital and provider negotiations than patient price shopping, given the difficulty of switching insurers. (Copyright © Congress of Neurological Surgeons 2022. All rights reserved.)
Databáze:	MEDLINE
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