Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR.
J Arthroplasty. 2022 Aug;37(8):1514-1519. doi: 10.1016/j.arth.2022.03.070. Epub 2022 Mar 26.
The Centers for Medicare and Medicaid Services (CMS) has mandated all hospitals to publish the charges of 300 common procedures to provide price transparency. The aims of our study are to evaluate 50 top orthopedic hospitals to determine compliance with this mandate and to assess the ease of finding cost information for arthroplasty procedures.
The websites of the top 50 US News and World Report (USNWR) orthopedic hospitals were searched to find publicly accessible procedural charges. Data included the number of clicks to locate pricing documents, number of files provided, and number of data rows pertaining to arthroplasty. Charge data was queried based on Diagnosis related group (DRG) codes (469, 470), Current Procedural Technology (CPT) codes (27130, 27477), and keyword searches ("arthroplasty", "total hip", and "total knee").
Forty-four (88%) of the top 50 USNWR Orthopedic institutions had publicly accessible files containing cost information. Thirty three of the 44 institutions provided results with DRG search while less than 10 institutions used CPT and keyword searches. There was an average of 226,190 (range 304-1,121,876) rows of data per file. Average charges varied depending on the use of DRG, CPT or keyword searches ($6,663-$117,072).
The majority of compliant hospitals published large data files requiring the use of DRG codes to find cost information with extreme variation in resultant charges provided. These findings underscore the lack of direct patient benefit afforded by the current mandate, as pricing determinations require expert knowledge in medical coding and have a high variability in the reported charges.
医疗保险和医疗补助服务中心（CMS）已要求所有医院公布 300 种常见手术的收费标准，以提供价格透明度。我们的研究旨在评估 50 家顶级骨科医院，以确定其是否遵守这一规定，并评估寻找关节置换手术成本信息的难易程度。
搜索了美国新闻与世界报道（USNWR）前 50 名骨科医院的网站，以查找公开获取的程序收费信息。数据包括找到定价文件所需的点击次数、提供的文件数量以及与关节置换术相关的数据行数。根据诊断相关组（DRG）代码（469、470）、当前程序技术（CPT）代码（27130、27477）和关键字搜索（“关节置换术”、“全髋关节”和“全膝关节”）查询收费数据。
在 50 家顶级 USNWR 骨科机构中，有 44 家（88%）有公开的文件，其中包含成本信息。33 家机构提供了 DRG 搜索结果，而不到 10 家机构使用 CPT 和关键字搜索。每份文件平均有 226190 行（范围 304-1121876 行）数据。平均费用因使用 DRG、CPT 或关键字搜索而异（$6663-$117072）。
大多数符合规定的医院公布了大型数据文件，需要使用 DRG 代码来查找成本信息，但提供的费用结果差异极大。这些发现突显出当前规定为患者带来的直接好处有限，因为定价决定需要医疗编码方面的专业知识，而且报告的费用差异很大。
