Pd08-12 What the Price Transparency Final Rule Teaches Us About Sex-Specific Services: Low Compliance and Regional Variability in Male Urological Procedures

You have accessJournal of UrologyHealth Services Research: Value of Care: Cost and Outcomes I (PD08) 1 May 2024PD08-12 WHAT THE PRICE TRANSPARENCY FINAL RULE TEACHES US ABOUT SEX-SPECIFIC SERVICES: LOW COMPLIANCE AND REGIONAL VARIABILITY IN MALE UROLOGICAL PROCEDURES Anna Ochsner, Borivoj Golijanin, Justin Bessette, Aaron Cleofas, Richard Glebocki, Christopher Tucci, Elias Hyams, and Gyan Pareek Anna OchsnerAnna Ochsner, Borivoj GolijaninBorivoj Golijanin, Justin BessetteJustin Bessette, Aaron CleofasAaron Cleofas, Richard GlebockiRichard Glebocki, Christopher TucciChristopher Tucci, Elias HyamsElias Hyams, and Gyan PareekGyan Pareek View All Author Informationhttps: //doi. org/10. 1097/01. JU. 0001008576. 33217. 96. 12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Per the Hospital Price Transparency Rule, effective January 1, 2021, the Centers for Medicare and Medicaid Services (CMS) requires hospitals to disclose prices for all services provided. The aim of this study was to evaluate regional price and disclosure variability for two key urologic services, prostate biopsy (CPT 55700) and robotic prostatectomy (CPT 55866), across hospitals providing urologic care in several United States (US) census divisions. Findings were then compared to mammography (CPT 77066), to determine any differences in reporting within Men's and Women's Health domains. METHODS: Self-pay prices for 2023 for services 55700, 55866, and 77066 were selected from chargemasters of hospitals providing urologic care listed in the US News and World Report Rankings (USNWRR). Hospitals from the Midwest (MW), Northeast (NE), and Pacific (P) states were included. Variance in price for these procedures was evaluated, rates of disclosure for each CPT and overall were calculated, and correlation with the USNWR ranking was analyzed. RESULTS: N=805 hospitals were included. MW comprised 42. 2% of the hospitals, NE 33. 5%, and P 24. 2%. For MW, NE, and P, price disclosure for 77066 was 89%, 86%, and 81%; for 55700 is 71%, 74%, and 70%; and for 55866 is 60%, 53%, and 56%; and disclosure of all three 47%, 46%, and 41%. Regionally there is significant variability in price of 55688 (F (2, 454) =34. 6, p=1E-14) ), 55700 (F (2, 578) =4. 03, p=0. 018) ), and 77066 (F (2, 689) =12. 66, p=0. 022). Median price of 55688 is 34, 351 (IQR 18338-62820) ; 55700 6, 825 (IQR 3617-12675) ; and 77066 was 472 (IQR 271-751). MW had the highest prices for 77066 (519, IQR 302-767) and 55700 (7, 383, IQR 4288-12666). Pacific states had the highest price for 55866 (59517, IQR 29129- 91700). Higher USNWR scores (out of 100) correlated with higher mammography (R=0. 163, p=0. 000017) and prostatectomy prices (R=0. 109, p=0. 02). CONCLUSIONS: Disclosure of prices for these urological procedures with CMS requirements is less frequent than that of mammography. Of the prices that were disclosed, there is significant regional variability, and prices for services tend to increase with hospital ranking on USNWR. Overall compliance with the final rule remains low, and men are faced with significant variability in the cost of urologic care. Further study of regional and hospital-level data may provide insight into variability and disclosure practices, toward the end of fairness toward patients, as well as sex-related differences in health service prices. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc. FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e178 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc. Metrics Author Information Anna Ochsner More articles by this author Borivoj Golijanin More articles by this author Justin Bessette More articles by this author Aaron Cleofas More articles by this author Richard Glebocki More articles by this author Christopher Tucci More articles by this author Elias Hyams More articles by this author Gyan Pareek More articles by this author Expand All Advertisement PDF downloadLoading. . .