Analysis of Out-of-Pocket Cost of Lung Cancer Screening for Uninsured Patients Among ACR-Accredited Imaging Centers

Febbo, Jennifer; Little, Brent P.; Fischl-Lanzoni, Natalia; Narayan, Anand K.; Tiersma, Keenae M.; Glover, McKinley; Shepard, Jo-Anne O.; Flores, Efrén J.

doi:10.1016/j.jacr.2020.03.001

Cited by 12 publications

(7 citation statements)

References 43 publications

(42 reference statements)

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“…Limited data are available regarding the out-of-pocket costs related to lung cancer screening, with even less information regarding the out-of-pocket costs related to the workup of incidentally detected indeterminate lesions [39]. In our cohort, more than 90% of the patients did not have any out-of-pocket costs related to the workup of incidentally detected lesions.…”

Section: Discussionmentioning

confidence: 75%

Detection of Extrapulmonary Malignancy During Lung Cancer Screening: 5-Year Analysis at a Tertiary Hospital

Chintanapakdee

Mendoza

Zhang

et al. 2020

Journal of the American College of Radiology

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Section: Discussionmentioning

confidence: 75%

Detection of Extrapulmonary Malignancy During Lung Cancer Screening: 5-Year Analysis at a Tertiary Hospital

Chintanapakdee

Mendoza

Zhang

et al. 2020

Journal of the American College of Radiology

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“…Since the implementation of the CMS price transparency rule, several studies have attempted to compare chargemaster charges among institutions for fewer items over larger geographic areas. [24][25][26] One study looked at six advanced diagnostic imaging services across the top 20 ranked hospitals in U.S. News and World Report. 25 Another study analyzed lowdose chest CT scans for lung cancer screening across 55 American College of Radiology accredited imaging centers across the United States.…”

Section: Discussionmentioning

confidence: 99%

“…25 Another study analyzed lowdose chest CT scans for lung cancer screening across 55 American College of Radiology accredited imaging centers across the United States. 24 A third study compared chargemaster data for four items across all 110 acute care hospitals in North Carolina. All studies found different hospital implementations of the chargemaster rule, marked variation in prices across institutions, and heterogeneous descriptions for items.…”

Section: Discussionmentioning

confidence: 99%

“…Although these specific price variations may not be generalizable to the rest of the United States, previous studies have identified high variation and prices across different items ranging from 56 to 4,916% difference across items and studies. [24][25][26] The study of chargemasters across North Carolina revealed a 358% variation across institutions ($72.00-258.00) for a complete blood count with differential. This price variation was not as extreme as was identified in our local market (1,375% variation, $48-708) for the same laboratory test.…”

Section: Chargemaster Charge Variationsmentioning

confidence: 99%

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Survey of Hospital Chargemaster Transparency

et al. 2021

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Background In January 2019, the Centers for Medicare & Medicaid Services (CMS) required hospitals to list their standard charges (chargemasters) publicly in an effort to increase price transparency in health care. Surveying hospital chargemasters may be informative to assess the implementation of this rule and its utility to consumers. Objective We aimed to compare hospital chargemaster data within a local hospital market where patients would reasonably try to shop or compare services. Methods We identified and aggregated Dallas County hospital chargemasters available in a database compatible format in May 2019. We manually examined a convenience sampling of 10 common laboratory tests, medications, and procedures. Results Thirteen hospital chargemasters were identified. Eleven hospitals had chargemasters available in a database compatible format (xlsx or csv). These 11 chargemasters were aggregated into a single file containing 155,576 chargeable items, prices, and descriptions. We observed heterogeneous names and descriptions of synonymous items across institutions, preventing automated comparisons. The examined items revealed a high variation in charges. The largest charge variation for laboratory tests examined included a 2,606% difference (partial thromboplastin time: $18.70–506.00), for medications an 18,617% difference (5-mg tablet of amlodipine: $0.23–43.05), and for procedures a 2,889% difference (circumcision: $252.00–7,532.10). One institution accounted for 27% of the lowest prices and another accounted for 60% of the highest prices. Conclusion Chargemaster data presentation varied among the hospitals surveyed, making automatic comparison impossible. Chargemaster data are difficult to interpret for health care decisions. Refining the minimum requirements for publishing chargemaster data could increase their utility.

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“…Though some recent studies have examined the financial toxicity to patients from diagnosis through an initial period of treatment or for a specific treatment regimen, virtually nothing is known about the financial burden patients face in their journey to obtain a definitive tissue diagnosis. Financial toxicity or financial stress related to treatment has been correlated with patient non-compliance with recommended treatment, a lower quality of life and more pain in cancer patients [2][3][4] The purpose of this study is to quantify and characterize patient out-of-pocket costs (OOPC) for lung cancer patients from the date of initial suspicious imaging to definitive diagnosis of lung cancer.…”

Section: Introductionmentioning

confidence: 99%

Patient out-of-pocket costs for suspicious pulmonary nodule biopsy in lung cancer patients

Zheng

Lavin

Sprafka³

2021

Journal of Medical Economics

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Aims: Dynamic changes in the payer landscape have resulted in increasing out-of-pocket costs (OOPC). Little is known about OOPC for patients undergoing biopsy for suspicious pulmonary nodules in the U.S. This study seeks to describe the spectrum of OOPC for diagnostic tissue sampling for suspicious pulmonary nodule with an ultimate diagnosis of lung cancer.Methods: Retrospective cohort study of adult patients with a primary lung cancer diagnosis and treatment who underwent diagnostic biopsy for suspicious pulmonary nodule utilizing IBM Marketscan ® Databases (2013 to 2017). Claims data included both total hospital and physician billed costs, insurer reimbursement and OOPC. Out-of-pocket costs were further stratified by type of biopsy, whether the patient underwent a single or multiple biopsies, and year of biopsy.Results: A total of 22,870 patients age 18-95 who underwent diagnostic lung biopsy were identified. The gender ratio was 49 to 51 for female;male, and 50% of patients were aged 65 or above. 78% of patients had a co-morbidity. The median OOPC for a patient receiving a single biopsy (any type

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Analysis of Out-of-Pocket Cost of Lung Cancer Screening for Uninsured Patients Among ACR-Accredited Imaging Centers

Cited by 12 publications

References 43 publications

Detection of Extrapulmonary Malignancy During Lung Cancer Screening: 5-Year Analysis at a Tertiary Hospital

Detection of Extrapulmonary Malignancy During Lung Cancer Screening: 5-Year Analysis at a Tertiary Hospital

Survey of Hospital Chargemaster Transparency

Patient out-of-pocket costs for suspicious pulmonary nodule biopsy in lung cancer patients

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