The Variation of Chargemaster Price Listings for Urogynecologic Procedures

Author:

Baban Saman1,Kasoff Madison2,Kadesh Amanda3,Chaudhary Richard4,Lui Aiden5,Shi Jeanne6,Ahluwalia Jai7,White Michael8,Giles Dobie9,Petersen Timothy R.10,Andiman Sarah11,Grimes Cara L.12

Affiliation:

1. Department of Obstetrics and Gynecology, University of California San Francisco, San Francisco, CA

2. Department of Obstetrics and Gynecology, University of Connecticut, Farmington, CT

3. Department of Obstetrics and Gynecology, Abington-Jefferson Health, Abington, PA

4. Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA

5. New York Medical College, Valhalla, NY

6. Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR

7. Department of Internal Medicine-Pediatrics, University of Rochester, Rochester, NY

8. Stern School of Business, New York University, New York, NY

9. Department of Obstetrics and Gynecology, University of Wisconsin, Madison, WI

10. Department of Anesthesiology, University of New Mexico, Albuquerque, NM

11. Department of Obstetrics and Gynecology, New York Medical College, Valhalla, NY

12. Departments of Obstetrics and Gynecology and Urology, New York Medical College, Valhalla, NY and Westchester Medical Center Health Network, Valhalla, NY.

Abstract

Importance A 2018 Executive Order calling for price transparency required hospitals to publicly provide chargemasters, which are detailed lists of standard price listings for billable medical procedures. Objectives The objective of this study was to evaluate price listing variations in common urogynecology procedures. Study Design This was a cross-sectional study of chargemasters obtained between February and April 2020 from hospitals across 5 states chosen to reflect the diversity of health systems in the United States. Hospital characteristic and quality metric data were obtained from the Homeland Infrastructure Foundation, U.S. Department of Agriculture, and U.S. Centers for Medicare & Medicaid Services websites. Current Procedural Terminology codes and procedure names for 9 urogynecologic procedures were used to search each chargemaster and extract price listings. Price listings were compared with data on quality, population demographics, and hospital characteristics to determine if any significant relationships existed. Results Eight hundred thirty-four chargemasters were identified. Price listings for most procedures differed significantly across the 5 states, including colpocleisis, cystoscopy with chemodenervation, diagnostic cystoscopy, diverticulectomy, sacral neuromodulation, midurethral sling, and sacrospinous ligament fixation. Price listings were significantly higher in urban hospitals than rural hospitals for 6 procedures. No significant association was seen with price listing and quality measures for most procedures. Conclusions Listed prices varied for several urogynecologic procedures. Some of this variation is associated with hospital characteristics such as urban setting. However, notably, price listing was not associated with quality. Further investigation of chargemaster price listings with hospital characteristics and quality metrics and with what is actually paid by patients is imperative for patients to navigate charges.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Urology,Obstetrics and Gynecology,Surgery

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