Payer-Negotiated Price Variation and Relationship to Surgical Outcomes for the Most Common Cancers at NCI-Designated Cancer Centers

Oncologic Surgery in the United States: Do You Get What You Pay For?

“…1,2 As a result of legislation that began in early 2021, hospitals are required to post payer-specific negotiated charges and discounted cash prices in machine-readable files and to disclose these charges for 300 "shoppable" services, 70 of which were specified by the Center for Medicare & Medicaid Services (CMS).The recent study by Sankaran et al, which examined payer-negotiated price discrepancies among National Cancer Institute (NCI)-Designated Cancer Centers for surgical management, sheds critical light on the state of healthcare pricing transparency and its implications. 3 The findings present a sobering reality: despite efforts to encourage informed patient decision-making and foster competitive pricing, the current landscape falls far short of achieving these goals.One of the pivotal revelations of this study is the stark contrast in compliance rates with federal regulations mandating price transparency across different service types, with radiology services exhibiting the highest adherence. This discrepancy not only underscores systemic shortcomings in enforcing transparency but also raises questions about the efficacy of existing auditing mechanisms.…”

“…The recent study by Sankaran et al, which examined payer-negotiated price discrepancies among National Cancer Institute (NCI)-Designated Cancer Centers for surgical management, sheds critical light on the state of healthcare pricing transparency and its implications. 3 The findings present a sobering reality: despite efforts to encourage informed patient decision-making and foster competitive pricing, the current landscape falls far short of achieving these goals.…”

“…The study's inability to establish a meaningful correlation between prices and patient outcomes for colon, lung, and pancreatic cancer further amplifies this concern, debunking the presumption that higher prices equate to superior care. 3 Conversely, higher price does not translate to poor quality.…”