Engagement platform vendor Change Healthcare's latest quarterly Healthcare Transparency Index (HCTI) reveals that the widest variation in costs for selected inpatient procedures and imaging services is found among the facilities where the procedure or service is performed-- not among the professionals who performed them.

"We often hear that doctors' fees are to blame for escalating healthcare costs," said Doug Ghertner, president and CEO of the Nashville-based company. "In truth, it's the facilities that exhibit the most significant variance in costs--often varying by hundreds or even thousands of percentage points."

The Q1 2014 HCTI identified knee and hip replacements to be the procedures that vary most based on facility, with prices ranging by 1,687 percent ($1,803 to $32,225) and 1,132 percent ($2,613 to $32,190) respectively. The professional fees for knee replacements varied 127 percent ($1,864 to $4,229) and the professional fees for hip replacements varied 151 percent ($1,669 to $4,190).

Other procedures showing substantial price discrepancies at the facility level included CT scans (469 percent), ultrasounds (350 percent) and vaginal deliveries (319 percent).

The index includes a Transparency Matrix, which identifies services that are both high cost and highly variable in price. Examining data from the first quarter of 2014, eight services fell into the Matrix's Target quadrant, including four in-patient procedures and four imaging services. To best analyze what was driving the significant variability, the HCTI segmented facility-specific costs, such as room and board, labs and anesthesia, from those related to professional fees.

The HCTI report is a quarterly measure of the costs and cost variability of various medical and dental services that consumers purchase on a recurring basis over time. The source of the healthcare cost data is the aggregation of in-network medical and dental claims from credentialed providers across all Change Healthcare clients, which has geographic coverage that spans nationally and covers 7 million lives.

The full report is available here (registration required).

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