Reported Prices for High-Volume Hand Surgery in the Era of Price Transparency: Implications for Future Policy Iterations.

Abstract

Background: In 2021, the United States enacted a law requiring hospitals to report prices for health care services. Across several health care services, poor compliance and wide variation in pricing was found. This study was performed to investigate variation in reporting and listed prices by hospital features for high-volume hand procedures, including carpal tunnel release, trigger finger release, de Quervain tenosynovitis release, and carpometacarpal arthroplasty.

Methods: The Turquoise Health price transparency database was used to obtain listed prices and linked to hospital characteristics from the 2021 Annual American Hospital Association Survey. This study used descriptive statistics and generalized linear regression.

Results: The analytic cohort included 2652 hospitals from across the United States. The highest rate of price reporting was in the Midwest (52% [ n = 836]) and lowest in the South (39% [ n = 925]). Compared with commercial insurers ($3609 [95% CI, $3414 to $3805]), public insurance rates were significantly lower (Medicare: $1588 [95% CI, $1484 to $1693], adjusted difference -$2021, P < 0.001; Medicaid: $1403 [95% CI, $1194 to $1612], adjusted difference -$2206, P < 0.001). Listed rates for self-pay patients were not statistically different from commercial rates.

Conclusions: Although pricing for high-volume elective hand procedures is frequently reported, a high proportion of hospitals do not report prices. These data highlight the need for future transparency policy to include pricing for high-volume hand surgery to give patients the ability to make financially informed choices. These results are a valuable aid for surgeons and patients to promote financially conscious decisions.