Facility Costs, Not Professional Fees, Account for Widely Varying Prices, According to Change Healthcare’s Q1 Healthcare Transparency Index
Prices for Hip, Knee Replacements Range by More Than 1,000 Percent from Facility to Facility
BRENTWOOD, Tenn., Aug. 5, 2014 /PRNewswire/ — Change Healthcare’s latest quarterly Healthcare Transparency Index (HCTI) revealed that the widest variation in costs for selected inpatient procedures and imaging services is found among the facilities where the procedure or service is performed – not among the professionals who performed them.
“We often hear that doctors’ fees are to blame for escalating healthcare costs,” said Doug Ghertner, president and CEO of Change Healthcare, the market leader in consumer engagement and cost transparency. “In truth, it’s the facilities that exhibit the most significant variance in costs – often varying by hundreds or even thousands of percentage points.”
The Q1 2014 HCTI identified knee and hip replacements to be the procedures that vary most based on facility, with prices ranging by 1,687 percent and 1,132 percent respectively. Other procedures showing substantial price discrepancies at the facility level included CT scans (469 percent), ultrasounds (350 percent) and vaginal deliveries (319 percent).
“Patients can save an enormous amount of money by asking their doctor, in advance, at which local hospital or surgery center he or she has privileges to perform a surgery or deliver a baby – and then shopping around,” Ghertner said. “As an example, for imaging services, an independent clinic or outpatient imaging facility often delivers the best value.”
The HCTI report is part of an ongoing effort by Change Healthcare to keep a pulse on the cost and cost variability of various medical and dental services, and to identify the greatest opportunities for savings for consumers and plan providers.
To uncover savings opportunities, Change Healthcare’s HCTI includes a Transparency MatrixTM, which identifies services that are both high cost and highly variable in price. Examining data from the first quarter of 2014, eight services fell into the Matrix’s Target quadrant, including four in-patient procedures and four imaging services. To best analyze what was driving the significant variability, the HCTI segmented facility-specific costs, such as room and board, labs and anesthesia, from those related to professional fees.
Here are the price ranges and variability for each procedure, broken down by facility and professional costs.
|
In-Patient Procedure |
Price Range |
Price Variability |
|
Knee replacement – facility |
$1,803-$32,225 |
1,687% |
|
Knee replacement – professional |
$1,864-$4,229 |
127% |
|
Hip replacement – facility |
$2,613-$32,190 |
1,132% |
|
Hip replacement –professional |
$1,669-$4,190 |
151% |
|
Vaginal delivery – facility |
$2,549-$10,679 |
319% |
|
Vaginal delivery – professional |
$2,179-$3,033 |
39% |
|
C-Section – facility |
$5,300-$15,962 |
201% |
|
C-Section – professional |
$2,097-$3,284 |
57% |
Here are the price ranges and variability for each type of imaging service, broken down by facility and professional costs.
|
Imaging Service |
Price Range |
Price Variability |
|
CT scans – facility |
$410-$2,334 |
469% |
|
CT scans – professional |
$71-$213 |
202% |
|
MRI – facility |
$596-$2,529 |
324% |
|
MRI – professional |
$85-$280 |
230% |
|
Ultrasounds – facility |
$124-$559 |
350% |
|
Ultrasounds – professional |
$34-$92 |
175% |
|
Mammograms – facility |
$132-$347 |
163% |
|
Mammograms – professional |
$38-$84 |
121% |
The HCTI report, available at http://www.changehealthcare.com/resources/publications/hcti, is a quarterly measure of the costs and cost variability of various medical and dental services that consumers purchase on a recurring basis over time. The source of the healthcare cost data is the aggregation of in-network medical and dental claims from credentialed providers across all Change Healthcare clients, which has geographic coverage that spans nationally and covers 7 million lives.
About Change Healthcare
Established in 2007, Change Healthcare is on a mission to transform the way Americans purchase and utilize healthcare services by driving sustainable engagement at the individual level. With a national client base of health plans and employers covering lives in all 50 states, and 7 million users on its platform, Change Healthcare is the premier national provider of healthcare cost transparency and consumer engagement solutions that enable consumers to: better understand and utilize their healthcare benefits; make informed healthcare purchasing decisions based on quality, cost and convenience; and manage higher out-of-pocket responsibility and realize savings. This, in turn, helps plan sponsors: control their healthcare cost growth trend; successfully migrate to more cost-effective plan types; optimize existing wellness programs and on-site clinics; and improve member/employee satisfaction and retention. To learn more, visit www.changehealthcare.com.
Contact: Laura Alabed-Olsson
Senior Manager, Marketing and Communications
Change Healthcare Corporation
(615) 775-9441
lalabedolsson@changehealthcare.com
SOURCE Change Healthcare
