Background: While multiple measures reflecting high value healthcare impact cancer center accreditation status, price transparency is not included despite important implications for a patient’s healthcare decisions. Our study reports the rates of price disclosure of surgical procedures for five cancers (Breast, Lung, Melanoma, Colon, and Prostate) among hospitals ranked by the American College of Surgeon’s Commission on Cancer (CoC). Methods: We identified non-federal, adult, and non-critical access CoC accredited hospitals and used a commercial database compiled by Turquoise Health to perform a cross-sectional analysis of hospital price disclosures for five common oncologic procedures (mastectomy, lobectomy, wide local excision for melanoma, partial colectomy, and prostatectomy). Publicly available financial reporting data were used to compile facility-specific features including bed size, teaching status, Center for Medicare and Medicaid wage index, and patient revenues. Modified Poisson regression, adjusted for hospital financial performance, was used to evaluate the association between price disclosure and CoC accreditation. Results: Of 1,078 CoC accredited hospitals, 547 (50.7%) did not disclose prices for any of the surgical procedures. 531 (49.3%) hospitals reported at least one procedure price, but only 313 (29.0%) hospitals reported prices for all five procedures (Figure). Of the five oncologic procedures, prostatectomy and lobectomy had the lowest price disclosure rates (Table). Disclosing and non-disclosing hospitals differed in CoC accreditation, ownership type and teaching status (all p<0.05). Hospitals that disclosed pricing information were more likely to receive Medicaid disproportionate share hospital payments, have lower average charge to cost ratios (or markups) (4.50vs5.10, p<0.001), and have lower net hospital margins (-2.02vs0.33, p=0.008). After adjustment, a one-point increase in markup was associated with a 4.6% higher likelihood (95% confidence interval: 2.1%-7.2%, p<0.001) of nondisclosure. Conclusions: Over half of the hospitals did not disclose prices for any of the five most common oncologic procedures despite their CoC accreditation. Hospital non-disclosure is associated with higher overall markup and net hospital margins. It remains difficult for patients to obtain price transparency for common oncologic procedures even at centers of excellence, signaling a discordance between quality measures visible to patients.
HSR22-183 Table 1. Characteristics of American College of Surgeon Commission on Cancer (CoC) Accredited Hospitals by Price Disclosures
*National Cancer Institute (NCI)
Price disclosure of hospitals with a designation from the American College of Surgeons Commission on Cancer.
Citation: Journal of the National Comprehensive Cancer Network 20, 3.5; 10.6004/jnccn.2021.7274
