Patel Shrey, Mastropierro Julianna, Spagnuolo Genevieve, Kosarchuk Jacob, O'Brien Monica, Wu Julian, Heilman Carl, Noonan Kathryn
Tufts University School of Medicine, Boston, Massachusetts, United States.
Department of Otolaryngology-Head and Neck Surgery, Tufts Medical Center, Boston, Massachusetts, United States.
J Neurol Surg B Skull Base. 2024 May 1;86(2):123-128. doi: 10.1055/s-0044-1786367. eCollection 2025 Apr.
Due to the escalating health care costs in the United States, the Centers for Medicare and Medicaid Services (CMS) implemented a cost transparency initiative on January 1, 2021. Hospitals lack functional cost estimators or fail to provide pricing information for common skull base procedures. A list of the top 70 neurosurgery and otolaryngology hospital systems according to the US News and World Report rankings was made. Google searches for each hospital's cost estimator tool were conducted, recording its presence and accessibility time. Using the cost estimator tool, specific skull base procedure prices, Current Procedural Terminology codes, and contact information for personalized estimates were searched. Fifty-seven hospitals (81%) were privately funded. The majority were urban teaching hospitals ( = 68; 97%). Geographical locations included 19 (27%) in the Northeast, 21 (30%) in the Midwest, 20 (29%) in the South, and 10 (14%) in the West. Of the 70 hospitals, 4 (5.7%) did not have a cost estimation website. Of the 66 hospitals that did, the average time to locate the cost of the skull-based procedures was 17.8 seconds (range 12-28 seconds). Only two (2.9%) hospitals had information for skull base procedures; both were radiosurgery procedures. The most common stereotactic radiosurgery offered was gamma knife radiosurgery ( = 50; 71%). A total of 19 hospitals (27%) did not include contact information for personalized cost estimation. The CMS price transparency guidelines are not designed to encompass skull base procedures. Due to this ambiguity, patients are unable to make informed financial decisions when selecting treatment options.
由于美国医疗保健成本不断攀升，医疗保险和医疗补助服务中心（CMS）于2021年1月1日实施了一项成本透明度倡议。医院缺乏实用的成本估算工具，或未能提供常见颅底手术的定价信息。
根据《美国新闻与世界报道》的排名，列出了前70家神经外科和耳鼻喉科医院系统。对每家医院的成本估算工具进行了谷歌搜索，记录其是否存在及可访问时间。使用成本估算工具，搜索了特定颅底手术的价格、当前手术操作术语代码以及个性化估算的联系信息。
57家医院（81%）为私立医院。大多数是城市教学医院（n = 68；97%）。地理位置包括东北部19家（27%）、中西部21家（30%）、南部20家（29%）和西部10家（14%）。在70家医院中，4家（5.7%）没有成本估算网站。在有成本估算网站的66家医院中，找到颅底手术成本的平均时间为17.8秒（范围为12 - 28秒）。只有两家（2.9%）医院有颅底手术的信息；均为放射外科手术。最常见的立体定向放射外科手术是伽玛刀放射外科手术（n = 50；71%）。共有19家医院（27%）未包括个性化成本估算的联系信息。
CMS的价格透明度指南并非旨在涵盖颅底手术。由于这种不明确性，患者在选择治疗方案时无法做出明智的财务决策。
