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Variable Accessibility to Consumer Pricing Among Breast Cancer Operations

  • Global Health Services Research
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The Centers for Medicare & Medicaid Services (CMS) mandate that every US hospital provide public online pricing information for services rendered. This allows patients to compare prices across hospital systems before establishing care. The goal of this project was to evaluate hospital compliance and patient-level accessibility to price transparency for common breast cancer surgical procedures.

Methods

A sample case of a 62-year-old female with a T2N0 breast cancer was chosen. The patient would have the option of undergoing a partial mastectomy or mastectomy, both with sentinel lymph node biopsy (SLNB). Eight Massachusetts academic medical centers were evaluated. Searches were performed by authors for each hospital system and procedure using the sample case.

Results

Every hospital had a cost calculator on its website. The average success rate of establishing a cost for partial mastectomy, mastectomy, and SLNB was 58, 35, and 25%, respectively. The median time to reach the cost calculator tool was 32 s (range 25–37 s). In successful attempts, the median pre-insurance estimated cost of a partial mastectomy was $16,509 (range $11,776–22,169), compared with $24,541 (range $16,921–25,543) for mastectomy and $12,342 (range $4034–20,644) for SLNB. SLNB costs varied significantly across hospitals (p = 0.025), but no statistically significant difference was observed for partial mastectomy or mastectomy.

Conclusion

Despite new regulatory requirements by CMS for increased price transparency for surgical procedures, our results demonstrate poor success rates in obtaining cost estimates and significant variability of reported hospital charges. Further efforts to improve the quality of hospital cost estimate calculators are necessary for informed decision-making for patients with breast cancer.

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Funding

No funding was received for this study.

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Author notes

  1. Tina Moon, Joshua Bloom have contributed equally to the work.

Authors and Affiliations

  1. Department of Surgery, Tufts Medical Center, Boston, MA, USA

    Tina Moon MD, Joshua Bloom MD, Kerry Gaffney MD & Carly Wareham MD

  2. Tufts University School of Medicine, Boston, MA, USA

    George Youssef BS, Nishanth Ganeshbabu BS & Natalie Pawlak MS

  3. Division of Colon and Rectal Surgery, Department of Surgery, Tufts Medical Center, Boston, MA, USA

    Jason Hall MD, MPH, FACS

  4. Department of Surgery, Melrose-Wakefield Hospital, Melrose, MA, USA

    Salvatore Nardello DO

  5. Division of Plastic and Reconstructive Surgery, Department of Surgery, Tufts Medical Center, Boston, MA, USA

    Abhishek Chatterjee MD, MBA, FACS

Authors
  1. Tina Moon MD
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  2. Joshua Bloom MD
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  3. George Youssef BS
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  4. Kerry Gaffney MD
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  6. Nishanth Ganeshbabu BS
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  7. Natalie Pawlak MS
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  8. Jason Hall MD, MPH, FACS
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  9. Salvatore Nardello DO
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  10. Abhishek Chatterjee MD, MBA, FACS
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Corresponding author

Correspondence to Tina Moon MD.

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Disclosure

Dr. Abhishek Chatterjee is a consultant for 3M, Deroyal, Dillon, and Molynyke. The remaining authors have no conflicts of interest to disclose.

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Moon, T., Bloom, J., Youssef, G. et al. Variable Accessibility to Consumer Pricing Among Breast Cancer Operations. Ann Surg Oncol 30, 4631–4635 (2023). https://doi.org/10.1245/s10434-023-13520-5

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  • DOI: https://doi.org/10.1245/s10434-023-13520-5

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