Comparison of Publicly Available Pricing Information for Neurosurgical Vascular Procedures through Chargemasters of the Top U.S. Academic Hospitals. (16th November 2020)

• Record Type: Journal Article
• Authors: la Peña, Nicole De; Pollock, Jordan; Doan, Matthew; Patel, Naresh P
• Is Part Of: Neurosurgery. Volume 67(2010)Supplement 1
• Publication Date: 2020-11-16
• Subjects: Nervous system -- Surgery -- Periodicals; 617.48005
• DOI: 10.1093/neuros/nyaa447_124
• Languages: English
• ISSNs: 0148-396X

Abstract

Abstract: INTRODUCTION: In 2019, the Trump administration signed an Executive Order that directed the Secretary of Health and Human Services to lead regulation in requiring hospitals to publicly post standard hospital charges to increase the transparency of healthcare pricing for U.S. consumers. The Centers for Medicare and Medicaid Services has overseen the enforcement of these regulations and mandated that all hospitals publish chargemasters annually. METHODS: Websites for the top 20 ranked academic hospitals according to the U.S. News and World Report were searched in May 2020 for chargemaster publications. Hospitals that did not include standard pricing for various MS-DRG codes within their chargemasters were excluded from the study. The neurosurgical vascular procedures examined in this study include Intracranial Vascular Procedures with PDX Hemorrhage (DRG 022), Craniotomy and Endovascular Intracranial Procedures (DRG 027), and Carotid Artery Stent Procedures (DRG 036) with no major complications or comorbidities (without MCC or CC). RESULTS: All hospitals searched had publicly available chargemasters, while 15/20 (75%) of the top hospitals displayed prices according to MS-DRG codes in their chargemaster files. The median price for Intracranial Vascular Procedures with PDX Hemorrhage was $205, 635 with a range of prices between $41, 082-$517, 053. The median price for Craniotomy and Endovascular Intracranial Procedures was $107, 443 with a range of $69, 614-$274, 038. The median price for Carotid Artery Stent Procedures was $67, 483 with a range of $28, 089-$156, 914. Pricing variation between hospitals appeared to be the greatest in the MS-DRG code for Intracranial Vascular Procedures with PDX Hemorrhage, while pricing for Carotid Artery Stent Procedures seemed to have the least amount of variation. CONCLUSION: While chargemasters attempt to increase the transparency and availability of pricing options for healthcare consumers, there is a wide variation between prices charged by different hospitals for the same MS-DRG coded procedure. The new ability of U.S. consumers to view hospital prices prior to receiving health services might create more informed consumers, leading to more patients "shopping around" before committing to a specific hospital.