Appl Clin Inform 2021; 12(02): 391-398
DOI: 10.1055/s-0041-1729168
Research Article

Survey of Hospital Chargemaster Transparency

Simone Arvisais-Anhalt
1  Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, United States
,
Samuel McDonald
2  Department of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, United States
3  Clinical Informatics Center, University of Texas Southwestern Medical Center, Dallas, Texas, United States
,
Jason Y. Park
1  Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, United States
4  Eugene McDermott Center for Human Growth and Development, University of Texas Southwestern Medical Center, Dallas, Texas, United States
,
Kandice Kapinos
5  Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, United States
6  Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, United States
7  RAND Corporation, Arlington, Virginia, United States
,
Christoph U. Lehmann
3  Clinical Informatics Center, University of Texas Southwestern Medical Center, Dallas, Texas, United States
5  Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, United States
8  Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, United States
9  Lyda Hill Department of Biostatistics, University of Texas Southwestern Medical Center, Dallas, Texas, United States
,
Mujeeb Basit
3  Clinical Informatics Center, University of Texas Southwestern Medical Center, Dallas, Texas, United States
5  Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, United States
› Author Affiliations
Funding None.

Abstract

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.

Protection of Human and Animal Subjects

This study did not include human or animal subjects.


Supplementary Material



Publication History

Received: 19 November 2020

Accepted: 26 March 2021

Publication Date:
05 May 2021 (online)

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