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Rates of price disclosure associated with the surgical treatment of early-stage breast cancer one year after implementation of federal regulations

  • Original Laboratory Investigation
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Abstract

Purpose

Mastectomy, breast reconstruction (BR) and breast conserving therapy (BCT) are core components of the treatment paradigm for early-stage disease but are differentially associated with significant financial burdens. Given recent price transparency regulations, we sought to characterize rates of disclosure for breast cancer-related surgery, including mastectomy, BCT, and BR (oncoplastic reconstruction, implant, pedicled flap and free flap) and identify associated factors.

Methods

For this cross-sectional analysis, cost reports were obtained from the Turquoise Health price transparency platform for all U.S. hospitals meeting national accreditation standards for breast cancer care. The Healthcare Cost Report Information System was used to collect facility-specific data. Addresses were geocoded to identify hospital referral and census regions while data from CMS was also used to identify the geographic practice cost index. We leveraged a Poisson regression model and relevant Medicare billing codes to analyze factors associated with price disclosure and the availability of an OOP price estimator.

Results

Of 447 identified hospitals, 221 (49.4%) disclosed prices for mastectomy and 188 42.1%) disclosed prices for both mastectomy and some form of reconstruction including oncoplastic reduction (n = 184, 97.9%), implants (n = 187, 99.5%), pedicled flaps (n = 89, 47.3%), and free flaps (n = 81, 43.1%). Non-profit status and increased market competition were associated with price nondisclosure. 121 hospitals (27.1%) had an out-of-pocket price estimator that included at least one breast surgery.

Conclusions

Most eligible hospitals did not disclose prices for breast cancer surgery. Distinct hospital characteristics were associated with price disclosure. Breast cancer patients face persistent difficulty in accessing costs.

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Acknowledgements

We would like to acknowledge Dr. Anaeze Offodile II, MD, MPH for his guidance and support.

Funding

No funding was used for this manuscript.

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Authors and Affiliations

  1. Division of Plastic Surgery, Department of Surgery, Northwestern Feinberg School of Medicine, Chicago, IL, USA

    Shivani A. Shah

  2. Duke National Clinician Scholar Program, Durham, NC, USA

    Yuqi Zhang & Marcelo Cerullo

  3. Department of Surgery, Yale New Haven Hospital, New Haven, CT, USA

    Yuqi Zhang

  4. Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Arlene M. Correa

  5. Harvard Medical School, Boston, MA, USA

    Baraa A. Hijaz & Alan Z. Yang

  6. Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA

    Oluwadamilola M. Fayanju

  7. Department of Surgery, Duke University Hospital, Durham, NC, USA

    Marcelo Cerullo

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  1. Shivani A. Shah
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Correspondence to Marcelo Cerullo.

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Shah, S.A., Zhang, Y., Correa, A.M. et al. Rates of price disclosure associated with the surgical treatment of early-stage breast cancer one year after implementation of federal regulations. Breast Cancer Res Treat 203, 397–406 (2024). https://doi.org/10.1007/s10549-023-07160-2

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  • DOI: https://doi.org/10.1007/s10549-023-07160-2

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