Insurers pay more to NCI centers for cancer surgeries than community hospitals, study finds

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Commercial insurers pay more for surgeries at National Cancer Institute-designated centers compared to community hospitals without differences in care utilization, according to findings recently published in JAMA Network Open.

Using data from three large U.S. commercial insurers, researchers analyzed spending and utilization for 66,878 breast, colon or lung cancer patients who underwent cancer-directed surgery from 2011-14. 

Private insurers paid NCI-designated cancer centers significantly higher for cancer surgery episodes — an average of $18,526 — compared to community hospitals, which were paid an average of $14,771, according to the findings published Aug. 3. 

Ninety-day post-discharge payments to NCI centers were also higher at about $47,035 compared to $41,291 paid to community hospitals. Meanwhile, researchers did not observe significant differences in length of stay, emergency department use or hospital readmission within 90 days of discharge. 

"The higher spending for NCI-designated cancer centers compared with community hospitals, despite similar utilization, suggests that the observed differences were driven by higher prices negotiated by these cancer centers with commercial payers," researchers said. "A better understanding of the factors associated with prices and spending at NCI cancer centers is needed." 

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