Transparency, Repricing, and Price Convergence in Cancer Care

Abstract

Objectives

Cancer imposes a significant economic burden on the US healthcare system and its patients. We quantified changes in price levels and variation for oncologic services after federal price transparency regulations and evaluated whether the prevalence and granularity of disclosures were associated with these changes.

Methods

This retrospective longitudinal study used nationwide hospital price transparency data from December 2021 to June 2024. The data set included billing codes across 4 oncology service categories (inpatient, chemotherapy administration, radiation, and surgery). A linear mixed-effects model evaluated the annualized real rate change (ARRC) as a function of local market-specific percentile price rank, transparency measures, service category, payer, market structure, and health system.

Results

Data were extracted for 89 billing codes from 228 hospitals, yielding 11 290 negotiated rate groups and 349 990 monthly observations. Each 10-percentage-point increase in code-level transparency was associated with a 0.82-percentage-point decrease in ARRC (P .01).

Conclusions

After federal price transparency regulations, markets with greater code-level transparency experienced larger price reductions, and prices converged as variation between high- and low-priced hospitals declined. These findings suggest transparency may promote more efficient and affordable cancer care, although the overall impact on spending and access remains uncertain.

Authors

Forrest Xiao Lily Boe Dan Snow Matthew Dimaano David Rubin Jonas Nelson Babak J. Mehrara Evan Matros Danielle H. Rochlin

Your browser is out-of-date

ISPOR recommends that you update your browser for more security, speed and the best experience on ispor.org. Update my browser now

×