Analysis of Hospital Quality Measures and Web-Based Chargemasters, 2019: Cross-sectional Study (Preprint)

Abstract

The federal health care price transparency regulation from 2019 is aimed at bending the health care cost curve by increasing the availability of hospital pricing information for the public.

This study aims to examine the associations between publicly reported diagnosis-related group chargemaster prices on the internet and quality measures, process indicators, and patient-reported experience measures.

In this cross-sectional study, we collected and analyzed a random 5.02% (212/4221) stratified sample of US hospital prices in 2019 using descriptive statistics and multivariate analysis.

We found extreme price variation in <i>shoppable</i> services and significantly greater price variation for medical versus surgical services (<i>P</i>=.006). In addition, we found that quality indicators were positively associated with standard charges, such as mortality (β=.929; <i>P</i>&lt;.001) and readmissions (β=.514; <i>P</i>&lt;.001). Other quality indicators, such as the effectiveness of care (β=−.919; <i>P</i>&lt;.001), efficient use of medical imaging (β=−.458; <i>P</i>=.001), and patient recommendation scores (β=−.414; <i>P</i>&lt;.001), were negatively associated with standard charges.

We found that hospital chargemasters display wide variations in prices for medical services and procedures and match variations in quality measures. Further work is required to investigate 100% of US hospital prices posted publicly on the internet and their relationship with quality measures.