The cost of care can vary greatly — sometimes even 15-fold — for privately insured patients, according to a recently released study by the United Health Center for Health Reform.
Researchers analyzed data from the organization's "Premium Physician Designation Program," which has been used to track the quality and efficiency of physician practices since 2005. All told, the data include some 250,000 physicians operating in 41 different states.
In tracking costs of episodes of care for several common chronic health conditions, researchers found that costs could vary as greatly as 15-fold.
"The wide variation in episode costs suggests that meaningful opportunities to improve efficiency probably exist — and could have a major impact if realized, given that these conditions are highly prevalent," according to the study, published in Health Affairs.
Meanwhile, costs for major medical procedures also varied "substantially," though less dramatically in percentage terms when compared with chronic conditions, at about 2.5-fold. For example, the price tag for a cervical spine fusion could run anywhere from $26,227 to $41,431, or 58 percent higher, researchers found.
Some other findings from the study:
- In comparing geographical regions, research shows that costs for common chronic conditions in low-cost markets were typically 15 to 20 percent below the median. And in high-cost markets, the price was typically 15 to 20 percent higher.
- Along with costs, quality scores also varied among procedures, from 96 percent for vaginal birth, all the way down to 74 percent for knee surgery to remove a torn meniscus.
- However, United Health found no correlation between costs and quality of care across markets.