DeMasi Matthew, Sellke Nicholas, Mortach Sherry, Rhodes Stephen, Brant Aaron, Tay Kimberly, Sun Helen H, Ghayda Ramy Abou, Loeb Aram, Thirumavalavan Nannan
Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Urology Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
Int J Impot Res. 2025 Aug 13. doi: 10.1038/s41443-025-01152-0.
In response to the 2021 Hospital Price Transparency Regulation by The Centers for Medicare & Medicaid Services (CMS), we evaluated hospital-reported price transparency and variability for testosterone (T) testing across the United States (US). Using the Turquoise database, hospitals disclosing free or total T test prices were identified. Hospital characteristics were compared between price reporters and non-reporters. Multivariable regression identified reporting predictors and assessed price variability by test and payer type. Of 6700 hospitals, 51.7% reported at least one T test price. Reporting was more common among larger hospitals (median 100 vs. 75 beds, p < 0.001), non-profits (62.7 vs. 44.3%, p < 0.001), and those with higher compliance scores (4.5 vs. 3, p < 0.001). Regional variation was significant (p < 0.001), but no urban-rural differences were observed (p = 0.71). Median prices were $84.90 (Interquartile range $44.0, $138.0) for total T and $92.27 ($49.17, $144.35) for free T, varying by payer: $79.43 ($40.82, $131.32) for commercial insurance and $98.00 ($54.65, $148.84) for self-pay. On multivariable analysis, hospitals in competitive markets and with more beds tended to have lower prices, while hospital ownership did not significantly affect pricing. Despite the legislation, nearly half of hospitals fail to report prices, driving significant price variation and limiting informed consumer choices.
为响应美国医疗保险和医疗补助服务中心（CMS）2021年的医院价格透明度规定，我们评估了美国各地医院报告的睾酮（T）检测价格透明度和变异性。使用绿松石数据库，识别出披露游离或总T检测价格的医院。比较了价格报告医院和非报告医院的特征。多变量回归确定了报告预测因素，并按检测类型和付款人类型评估了价格变异性。在6700家医院中，51.7%报告了至少一种T检测价格。在大型医院（中位数为100张床位，而不是75张床位，p<0.001）、非营利性医院（62.7%对44.3%，p<0.001）以及合规得分较高的医院（4.5对3，p<0.001）中，报告更为常见。地区差异显著（p<0.001），但未观察到城乡差异（p=0.71）。总T的中位数价格为84.90美元（四分位间距为44.0美元，138.0美元），游离T的中位数价格为92.27美元（49.17美元，144.35美元），因付款人而异：商业保险为79.43美元（40.82美元，131.32美元），自费为98.00美元（54.65美元，148.84美元）。多变量分析显示，竞争市场中的医院和床位较多的医院价格往往较低，而医院所有权对定价没有显著影响。尽管有这项立法，但近一半的医院未能报告价格，导致价格差异巨大，并限制了消费者的明智选择。
