Variation in commercial prices for thyroidectomy and parathyroidectomy at US hospitals

Samuel J Enumah; David C Chang; Nancy L Cho; Carrie E Cunningham; Gerard M Doherty; Matthew A Nehs; Gregory W Randolph; Jason B Liu

doi:10.1016/j.amjsurg.2024.116072

Variation in commercial prices for thyroidectomy and parathyroidectomy at US hospitals

Am J Surg. 2024 Nov 6:241:116072. doi: 10.1016/j.amjsurg.2024.116072. Online ahead of print.

Authors

Samuel J Enumah¹, David C Chang², Nancy L Cho³, Carrie E Cunningham⁴, Gerard M Doherty³, Matthew A Nehs³, Gregory W Randolph⁵, Jason B Liu⁶

Affiliations

¹ Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA; Department of Surgery, Massachusetts General Hospital, Harvard Medical School, 15 Fruit Street, Boston, MA, 02114, USA. Electronic address: samuel_enumah@urmc.rochester.edu.
² Department of Surgery, Massachusetts General Hospital, Harvard Medical School, 15 Fruit Street, Boston, MA, 02114, USA; The Codman Center for Clinical Effectiveness in Surgery, Massachusetts General Hospital, 165 Cambridge Street, Suite 403, Boston, MA, 02114, USA.
³ Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
⁴ Department of Surgery, Massachusetts General Hospital, Harvard Medical School, 15 Fruit Street, Boston, MA, 02114, USA.
⁵ Massachusetts Eye and Ear Infirmary, Harvard Medical School, 243 Charles Street, Boston, MA, 02114, USA.
⁶ Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA; Patient-Reported Outcomes, Value, and Experience (PROVE) Center, Brigham and Women's Hospital, 1620 Tremont Street, Boston, MA, 02120, USA.

PMID: 39561478
DOI: 10.1016/j.amjsurg.2024.116072

Abstract

Background: The 2021 Hospital Price Transparency Rule mandated hospitals to publicly disclose their service prices to improve competition and lower healthcare costs. Our aim was to characterize commercial price variation for thyroidectomy and parathyroidectomy.

Methods: We performed a national cross-sectional study of hospital price variation in 2022 and 2023 using the Turquoise Health dataset. Our main outcomes were within- and across-hospital 90th-to-10th percentile commercial price ratios and a high commercial-to-Medicare (1.5) price ratio. We performed logistic regressions to identify hospital factors associated with a high commercial-to-Medicare price ratio.

Results: For 16,794 unique commercial rates across 564 facilities, within-hospital price ratios ranged from 2.0 to 2.4, and across-hospital price ratios ranged from 2.7 to 4.1. High market concentration and five-star hospital rating were associated with high commercial-to-Medicare price ratios compared to low market concentration and three-star hospital rating, respectively.

Conclusions: Notable variation exists within and across hospitals signaling facilities have negotiated different payments from insurance companies for the same service. Quality may be a modifiable factor to increase hospital revenue and improve care for patients.

Keywords: Endocrine; Health economics; Parathyroid; Price; Quality; Thyroid; Transparency.