Study Finds Significant Difference in Surgical Procedure Costs at In-Network Hospitals Versus Independent Facilities
A recent study, published in JAMA Network Open, compared the cost of surgical procedures performed at healthcare facilities within a network versus the same procedures performed at independent hospitals. The study found that in-network facilities charged significantly higher rates than independent facilities. For example, at an in-network hospital, the median cost for a shoulder arthroscopy was $4,432; at independent hospitals, the median cost was $2,643. Similarly, the median price for knee cartilage removal was $1,446 higher at in-network hospitals. Of the 16 procedures examined, 15 of them had lower median negotiated prices at the independent hospitals as compared to the in-network hospitals.
In 2021, Centers for Medicare & Medicaid Services (CMS), enacted the Hospital Price Transparency Rule, which requires all federally funded, US hospitals to provide clear and accessible pricing information online so that patients can “shop” for health services and make informed decisions. The study also found that only about 25% of hospitals are fully compliant with this rule. Because of this, it is extremely difficult for patients to navigate their own healthcare costs.
Alliance ENT & Hearing Center is an independent healthcare facility with the ability to perform life-enriching procedures directly in-office, including balloon sinuplasty and turbinate reduction. You can trust our providers to find the solution that best suits you—medically and financially. Save yourself a trip to the hospital and call us at (414) 727-0910 to schedule your appointment today.
Centers for Medicare & Medicaid Services. (2022, June 8). Hospital Price Transparency. CMS.gov. https://cms.gov/hospital-price-transparency
Mensik, H. (2023, Feb 14). Surgical procedures cost significantly more at hospitals in networks versus independent facilities, study finds. Healthcare Dive. https://healthcaredive.com/news/surgical-procedure-prices-hospital-network-vs-independent-JAMA-research/642717