Procedure Prices in Certain Markets 2-3 Times Higher Than Average

Research conducted by Thomson Reuters shows procedure prices in some markets that were two to three times higher than the average price for the same procedure.

The report uses claims data for Americans with employer-sponsored insurance to analyze variation in prices nationwide for a set of 300 "shoppable" procedures, such as a mammogram, knee replacement or MRI. Other key findings from the Thomson Reuters report include the following:

•    Price variation for common medical procedures costs Americans with employer-sponsored insurance as much as $36 billion a year.
•    A major driver of price variation is site of service: Prices vary significantly by care setting and the percentage of services done in the hospital versus an office setting.
•    A review of published literature tracking the relationship between price and quality of care reveals no positive correlation between price and quality.
•    Currently, 34 states require reporting of hospital charges or reimbursement rates, and another seven states have established a forum for voluntary price reporting.

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