February 14, 2023

Prices for surgical procedures in and out of hospital networks

By: Judy Mathias

Editor's Note

This study from the University of Michigan, Ann Arbor, finds that network facilities had higher negotiated prices for surgical procedures, and there is wide variability across facilities in and out of hospital networks.

A total of 3,195 hospitals were included in the analysis.

Among the findings:

  • For 15 of 16 procedures that the Centers for Medicare and Medicaid Services (CMS) requires hospitals receiving federal funding to release prices on, the median negotiated price was significantly higher at facilities within networks.
  • The median price for shoulder arthroscopy was 1.68 times higher at network facilities vs independent hospitals ($4,432 vs $2,643).
  • The median price for prostatectomy at network facilities was $9,567 vs $8,601 at independent facilities.

As more hospitals become compliant with this CMS policy, it will be important to understand the mechanisms behind the significant variations in prices for surgical care and identify areas of unwarranted variation, the researchers say.

JAMA (healthcare publication) Network logo


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