Wide variation in the cost and transparency of prices negotiated by payers for the treatment of thyroid cancer

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Hospital price transparency aims to help inform patients about the cost of services and procedures before receiving them. Since January 1, 2021, U.S. centers have been required by centers for Medicare and Medicaid Services (CMS) to provide pricing information on items and services.

A team of researchers from Brigham and Women’s Hospital and Massachusetts Eye and Ear took advantage of the available data to analyze and price variation for the treatment of . The team found that both transparency and price varied widely, with only half of them the centers studied the disclosure of reports on prices negotiated by payers and the cost of some services ranging up to 70 times. The results are published in JAMA.

“Reporting negotiated prices by payers is an important first step in helping patients estimate the cost of care before receiving treatment,” said corresponding author Roy Xiao, MD, MS, resident in head surgery and Brigham and Mass Eye and Ear otolaryngology neck. “Based on previous work, we expected to see some degree of variation, but the full range we saw in our study was certainly amazing.”

Although CMS requires disclosure of fees for all types of proceedings, Xiao and colleagues focused on them. cancer as a case study. Thyroid cancer treatment is known to impose significant financial burdens on patients. Among cancer patients, failure rates are higher in thyroid cancer patients.

The researchers characterized price availability and variation for thyroid cancer care in 52 centers designated by the National Cancer Institute (NCI) as of March 25, 2021. Half of the centers revealed that the merchants negotiated the taxpayer for any item or service. Even after normalizing for factors affecting the cost of care, the team found great variation between centers, with a 70-fold difference in the cost of radioactive iodine treatment and a 44-fold difference. in the cost of computed tomography of the neck. Within the centers, it also varied widely, depending on the insurer. On average, procedures such as fine-needle aspiration biopsy and thyroid uptake screening varied nearly fivefold at the centers.

The authors note that the CMS requires hospitals to disclose negotiated rates for physicians working in the hospital, but physicians practicing in hospitals are often hired by affiliated physician organizations, which may explain why many centers do not they reported surgeons ’fees for thyroid surgery. They also point out that the study was conducted shortly after the implementation of the price transparency requirements. As centers overcome barriers to compliance, outreach rates and transparency may increase.

“The centers are facing a new reality in terms of price transparency; they have never before been required to have these rates available, and it is a great boost to collect this information and make it available in a way. that it is intelligible to patients, ”he said. co-author Vinay Rathi, MD, MBA, resident in otorhinolaryngology: head and neck surgery at Brigham and Mass Eye and Ear. “As this information becomes available, we are interested in exploring how it can be used to help our patients.”

“The cost of health care is a fundamentally important issue,” said lead author Rosh KV Sethi, MD, MPH, head and neck surgeon at the Brigham and Dana-Farber Cancer Institute. “The introduction of price it is a step in the right direction for patients and clinicians to understand cost discrepancies. ”


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More information:
Roy Xiao et al, Prices negotiated by payers in the diagnosis and management of thyroid cancer in 2021, JAMA (2021). DOI: 10.1001 / jama.2021.8535

Citation: Wide variation in cost and transparency of prices negotiated by payers for thyroid cancer care (2021, June 4) retrieved June 5, 2021 at https://medicalxpress.com/news/2021- 06-wide-variation-transparency-payer-negotiated -preus.html

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