Over the last few decades, the number of rhinology procedures has increased significantly. This is primarily because of improvements in endoscopic sinus surgeries that use less invasive methods. At the same time, price transparency may be a crucial part of bringing down the cost of health care for rhinology patients who need these procedures.
In this study conducted at UNC Medical Center, a database of hospital-reported charges for commonly performed rhinology surgery was created at 121 hospitals affiliated with otolaryngology residency. Several attributes were gathered, including the hospital’s geographic location, the number of beds and physicians, and other population demographic data. A cross-sectional analysis of the results for nasal endoscopy, maxillary antrostomy, and nasal septoplasty was done based on data from a hospital web search for a shopping tool. The primary outcomes were gross charge and discount cash price. The findings were presented at the recent American Rhinologic Society Meeting in Philadelphia (Sep 9-10, 2022),
All procedures, except for nasal endoscopy, had a facility fee higher than the physician’s fee. The median gross charge for nasal endoscopy was $785. Prices for all three procedures were very different from one another. Nasal endoscopy had a minor variation in gross price, while nasal septoplasty had the greatest, ranging from $0 to $110,946.
According to the study results, 118 (98%) of the 121 hospitals disclosed prices, and 55 of the hospitals met CMS guidelines for one of the three rhinology procedures. Nasal endoscopy, nasal/sinus surgery, maxillary antrostomy, and nasal septoplasty were all included in 28%, 14%, and 26% of the shopping tools, respectively. The difficulty of transparency tools, on the other hand, varied across hospitals. Not all hospitals had the same user interface for shoppable tools; some tools were easier to use than others. Based on these results, people with rhinology have a limited ability to shop around and compare prices. Also, there isn’t much information about negotiating third-party rates, which isn’t enough to increase market competition and bring costs down for different procedures.
The level of price transparency and prices at hospitals that did list their prices were very different. Less than half of the hospitals gave all the prices for each procedure that CMS required. Gross and discount charges were the most common prices that gave consumers the information they needed to shop around and make better decisions about procedures based on what they might pay. Discount cost is essential for people who don’t have insurance and don’t care much about insured rates. More openness about these values could help patients save even more on medical costs.
In the future, researchers should look into the population’s demographics and socioeconomic factors that affect how prices change and how transparent they are in rhinology procedures. The data for this study were collected over a single period. However, an analysis of price changes over time would help determine if price transparency reduces price changes for standard outpatient rhinology procedures.