Study: Outpatient cancer care charges vary widely, exceed Medicare rates

Hospital pricing for outpatient oncology services varies widely and puts some patients at risk for high price markups, according to a study published in the American Journal of Managed Care.

The study — led by Martin Makary, MD, with the department of surgery at Baltimore-based Johns Hopkins Medicine — examined Medicare billing records for 3,248 hospitals nationwide in 2014. Researchers identified significant variation between submitted charges and the Medicare reimbursement amount across oncology specialty services.

Overall, specialty departments charged a median of up to 4.1 times more than the Medicare reimbursement amount, according to a news release. For radiology, the charge was a median of 3.7 times more, and for hematology/oncology, 2.3 times more. Medical oncology departments charged a median of 2.4 times more; radiation oncology 3.6 times more; and pathology 4.1 more.

"High markups exist for oncology services, and further legislation is needed to protect patients from highly variable pricing and to address disparities in access to high-quality cancer care," the study's authors concluded.

 

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