A new JAMA study found substantial cost variations in common cardiovascular tests and procedures across top US hospitals.
Boston-based researchers capitalized on the CMS Hospital Price Transparency rule (effective Jan 2021), which requires hospitals to publicly post projected out-of-pocket expenses, as well as payer-specific negotiated rates, for standard care services.
The investigators gathered data from the 20 highest-ranking US hospitals (including Cleveland Clinic, Cedars-Sinai Medical Center, and Brigham and Women’s Hospital) and identified the following median payer-negotiated ranges across the hospitals:
- Echocardiogram: $204 to $2,588
- Stress test: $463 to $3,230
- Right heart catheterization: $2,821 to $9,382
- Coronary angiogram: $2,868 to $9,203
- PCI: $657 to $25,521
- Pacemaker implantation: $506 to $20,002
Costs varied widely even for the same procedure within a single hospital, depending on the payer. Here are the largest payer-specific interquartile ranges (the spread of the middle 50% of data) the researchers saw within the hospitals:
- Echocardiogram: $470 to $3,022
- Stress test: $776 to $3,473
- RHC: $3,143 to $12,926
- Coronary angiogram: $4,011 to $14,486
- PCI: $11,325 to $23,392
- Pacemaker implantation: $8,474 to $22,694
The Takeaway
This study exposed huge hospital-level price variations for routine CV tests and procedures, which don’t seem to reflect differences in quality-of-care. The authors suggested that the variations “may instead reflect which stakeholder—hospital or insurance company—has stronger negotiating power in the boardroom, which is often dictated by market dynamics.”
