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

Abstract

To help patients make better-informed health care decisions and decrease overall health care expenditures, the Centers for Medicare and Medicaid Services established a price transparency law in 2021 requiring hospitals to publish price data. We investigated hospital compliance rates with price reporting, price variation for common hand surgery procedures, and the influence of hospital factors on price. Common Procedure Terminology (CPT) codes for 14 common hand procedures were searched in the Turquoise Health database for prices published by hospitals nationwide from March 2023 to August 2023. Hospital details were collected, and univariate and multivariable analyses assessed the relationship between hospital factors and price for each CPT code. A total of 769,349 contracted rates from 3,700 different hospitals were analyzed from 14 hand surgery CPT codes. The greatest price variation was seen with surgical treatment for Dupuytren disease, and the smallest price variation was seen with lesion excision. Multivariable analysis of hospital factors demonstrated geographic region, private ownership, and safety net status most affected price, whereas Medicare's hospital rating, status as an academic center, hospital bed size, and compliance with the price transparency law did not consistently influence price. Higher prices were found for hospitals in the Northwest and West regions, privately owned health care institutions, nonsafety net hospitals, and hospitals in urban settings. Since Centers for Medicare and Medicaid Services legislation enactment, there is continued variation in price transparency and cost of common hand surgery procedures, regardless of hospital ranking. The lack of transparency may place patients at a disadvantage, particularly when seeking a physician and hospital system for elective surgeries.