Heart surgery prices vary from one part of the US to the next
![Pricing for coronary artery bypass grafting (CABG) varies significantly throughout the United States, according to new findings published in the Journal of the American Heart Association.[1] Researchers emphasized that higher prices were not necessarily associated with better patient outcomes. Photo by Karolina Grabowska via Pexels](/sites/default/files/styles/top_stories/public/2021-08/usa_healthcare_costs.jpg.webp?itok=kJ1yC-u3)
Pricing for coronary artery bypass grafting (CABG) varies significantly throughout the United States, according to new findings published in the Journal of the American Heart Association.[1] Researchers emphasized that higher prices were not necessarily associated with better patient outcomes.
“In 2021, the Centers for Medicare and Medicaid Services (CMS) issued new price transparency guidelines requiring hospitals to provide detailed pricing information for the first time,” wrote first author Chen Wei, MD, a specialist with the department of medicine at Stanford University School of Medicine, and colleagues. “Here, price is the amount negotiated by the insurance company, which includes the payment from the insurance company to the hospital and any coinsurance payments for patients … Since the enactment of the new price transparency legislation, multiple studies have documented substantial variation in payer‐negotiated prices across a broad spectrum of medical services, including diagnostics, procedures, and prescription drugs. However, little has been published in the cardiovascular field, despite its contribution to overall U.S. healthcare spending.”
Wei et al. explored the new price transparency data, focusing on the costs associated with CABG at 544 hospitals across the United States. Overall, they wrote, there was “significant variation in price across payer categories, with chargemaster, self‐pay, and commercial rates being 4.96, 2.64, and 2.01 times the Medicare rate, respectively.” Prices also “varied substantially” from one region to the next. The lowest median CABG prices were found in the East South Central region ($35,624), while the highest were found in the Pacific region ($84,080).
Multiple hospital characteristics were associated with higher CABG prices, including higher inpatient revenue, more annual inpatient discharges and whether or not the site was a “major teaching hospital.”
Private equity-owned hospitals were also associated with higher CABG prices, but the difference was not statistically significant.
The group also found that, as one might expect, regions where healthcare spending and healthcare pricing are known to be higher were typically associated with higher CABG prices than hospitals in other regions. Another key finding was that regions with a higher number of hospital beds per 1,000 patients were associated with lower CABG prices.
The researchers did not identify a significant relationship between CABG price and a given region’s socioeconomic dynamics. Also, they highlighted the fact that there were no significant associations between CABG prices and 30-day mortality, CABG prices and hospital readmissions or CABG prices and CMS hospital ratings. These findings suggest quality is not directly tied to CABG pricing when patients seek treatment.
“There is significant inter‐ and intrahospital variation in negotiated prices for CABG,” the authors concluded. “Variations in CABG prices were associated with hospital characteristics but not with hospital quality. These data raise important questions about the efficiency of administration in the U.S. healthcare market.”
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.