At 1 Sutter hospital, commercial insurance rates for same procedure vary sevenfold

Within the same hospital, the negotiated rate for one procedure — a GI biopsy with an endoscope — can vary by nearly sevenfold, according to a new report from the Health Care Cost Institute. 

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HCCI researchers studied Sacramento, Calif.-based Sutter Health’s newly published negotiated rate information. The system has published rate information that spans all of its 24 hospitals in Northern California. 

Three things to know:

1. At Sutter’s California Pacific Medical Center-Van Ness in San Francisco, commercial insurance rates for a C-section delivery can vary by $52,688, depending on plan type.

2. HCCI found rate variation was more dramatic across hospitals within the Sutter system. Rates for some four-view knee X-rays at one hospital were more than 11 times as much as at others, and rates for some major lower joint replacements were nearly $60,000 more than others.

3. HCCI researchers said: “While it is unclear if the disclosure of these prices will influence any patients to change where they seek care, that employers can now see the various price levels across different health insurers might prompt more ‘smart shopping’ for their employees’ health insurance plan. This could, in turn, put more pressure on insurers to compete for customers through better negotiated rates.”

Read the full report here.

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