The Variation of Chargemaster Price Listings for Urogynecologic Procedures
Author Type(s)
Faculty
Document Type
Abstract
Publication Date
2022
Journal Title
International Urogynecology Journal
Department
Obstetrics and Gynecology
Abstract
Introduction: A 2018 Executive Order calling for price transparency required hospitals to provide chargemasters on their public websites. Chargemasters are detailed lists of standard prices for every billable medical procedure that a hospital provides. In the past, hospitals have used these documents to negotiate billing with third-party payers, such as health insurance companies. Objective: The goal of the study was to evaluate if significant price variations existed amongst hospitals for common procedures in urogynecology. Procedure prices were determined for each facility from its publicly available hospital chargemaster. Prices were then compared with data on quality, population demographics, and hospital characteristics to determine if any significant relationships existed. Through our investigation, we can evaluate if patients have accessible and relevant information to make informed decisions about their care. Methods: Chargemasters were obtained between February and April 2020 from hospitals across 5 states, which were chosen to reflect the diversity of health systems in the United States (US). Hospital characteristics and quality metric data were obtained from the Homeland Infrastructure Foundation, US Department of Agriculture and CMS websites. Current Procedural Terminology (CPT) codes and procedure names for 7 common urogynecologic procedures were used to search through each chargemaster and extract price listings. These included diagnostic cystoscopy, cystoscopy with botox, cystoscopy with hydrodistension, colpocleisis, interstim, diverticulectomy and sacrospinous ligament fixation. Results: 834 chargemasters across 5 US states were identified and downloaded from hospital websites. All hospital characteristics, population demographics and quality metrics data varied significantly across the 5 states. Not all procedures were listed in every chargemaster, ranging from sacrospinous ligament fixation (N=38, 4.6%) to diagnostic cystoscopy (N=648, 77.7%). Mean price listings for most of the procedures differed significantly across the 5 states. This included colpocleisis (p=0.001), cystoscopy with botox (p<0.001), diagnostic cystoscopy (p<0.024), diverticulectomy (p=0.002), interstim (p<0.001), and sacrospinous ligament fixation (p<0.001). 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 of the procedures. Conclusions: This study was a comprehensive evaluation of all available chargemasters from hospitals providing urogynecologic care across five US states. Overall, our findings demonstrate significant differences in charge for several of the urogynecologic procedures investigated. Some of this variation is associated with hospital characteristics such as urban setting. However, surprisingly, price listing was not associated with quality. It continues to be unclear whether there is any correlation between the listed prices and how much a patient actually pays. Further investigation of how chargemaster procedure prices are determined is imperative to allow patients to use this data in a meaningful way.
Recommended Citation
Baban, S., Kadesh, A., Chaudhary, R., Lui, A., Shi, J., Ahluwalia, J., White, M., Giles, D., Petersen, T., & Grimes, C. L. (2022). The Variation of Chargemaster Price Listings for Urogynecologic Procedures. International Urogynecology Journal, 33, S341. https://doi.org/10.1007/s00192-022-05295-2
