Variation in commercial prices for thyroidectomy and parathyroidectomy at US hospitals - 10/02/25

Doi : 10.1016/j.amjsurg.2024.116072

Samuel J. Enumah ^a,^b,^⁎ , David C. Chang ^b,^c, Nancy L. Cho ^a, Carrie E. Cunningham ^b, Gerard M. Doherty ^a, Matthew A. Nehs ^a, Gregory W. Randolph ^d, Jason B. Liu ^a,^e
^a Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
^b Department of Surgery, Massachusetts General Hospital, Harvard Medical School, 15 Fruit Street, Boston, MA, 02114, USA
^c The Codman Center for Clinical Effectiveness in Surgery, Massachusetts General Hospital, 165 Cambridge Street, Suite 403, Boston, MA, 02114, USA
^d Massachusetts Eye and Ear Infirmary, Harvard Medical School, 243 Charles Street, Boston, MA, 02114, USA
^e Patient-Reported Outcomes, Value, and Experience (PROVE) Center, Brigham and Women's Hospital, 1620 Tremont Street, Boston, MA, 02120, USA

^⁎Corresponding author. Brigham and Women's Hospital, Harvard Medical School, 45 Francis Street, ASB 2-3, Boston, MA, 02115, USA.Brigham and Women's HospitalHarvard Medical School45 Francis StreetASB 2-3BostonMA02115USA

Abstract

Background

The 2021 Hospital Price Transparency Rule mandated hospitals to publicly disclose their service prices to improve competition and lower healthcare costs. Our aim was to characterize commercial price variation for thyroidectomy and parathyroidectomy.

Methods

We performed a national cross-sectional study of hospital price variation in 2022 and 2023 using the Turquoise Health dataset. Our main outcomes were within- and across-hospital 90th-to-10th percentile commercial price ratios and a high commercial-to-Medicare (1.5) price ratio. We performed logistic regressions to identify hospital factors associated with a high commercial-to-Medicare price ratio.

Results

For 16,794 unique commercial rates across 564 facilities, within-hospital price ratios ranged from 2.0 to 2.4, and across-hospital price ratios ranged from 2.7 to 4.1. High market concentration and five-star hospital rating were associated with high commercial-to-Medicare price ratios compared to low market concentration and three-star hospital rating, respectively.

Conclusions

Notable variation exists within and across hospitals signaling facilities have negotiated different payments from insurance companies for the same service. Quality may be a modifiable factor to increase hospital revenue and improve care for patients.

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Graphical abstract

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Highlights

•	Commercial price variation contributes to high U.S. health care spending.
•	Thyroidectomy and parathyroidectomy prices display notable variation.
•	Hospital market concentration may impact commercial prices.
•	Superior quality may help hospitals negotiate higher prices.

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Keywords : Thyroid, Parathyroid, Endocrine, Price, Transparency, Quality, Health economics

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Vol 241

Article 116072- mars 2025 Retour au numéro

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Variation in commercial prices for thyroidectomy and parathyroidectomy at US hospitals - 10/02/25

Abstract

Background

Methods

Results

Conclusions

Graphical abstract

Highlights

Plan

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