Private payer spending on coronary stent placement, laparoscopic appendectomy and total hip replacement varies widely across the nation, according to a recent Government Accountability Office report. However, two metro areas were among those with the highest spending for all three procedures.
The GAO found spending on an episode of care varied across metropolitan statistical areas even after adjusting for geographic differences in the cost of doing business and differences in enrollee demographics and health status. Concerning the three procedures examined in the report, the GAO found the average adjusted episode spending for MSAs in the highest-spending quintile was 74 to 94 percent higher than MSAs in the lowest-spending quintile.
However, Steve Love, president of the Dallas-Fort Worth Hospital Council, told The Dallas Morning News hospital charges are typically more than the amount insurers pay, and the GAO report is unclear because it refers to prices as well as charges and reimbursements.
Here are the five metro areas identified by the GAO that have the highest spending on laparoscopic appendectomy episodes.
1. Salinas, Calif. — $25,924
2. Janesville, Wis. — $22,677
3. Fort Collins-Loveland, Colo. — $21,766
4. Anchorage, Alaska — $20,746
5. Reading, Pa. — $18,142
Here are the five metro areas identified by the GAO that have highest spending on total hip replacement episodes.
1. Salinas, Calif. — $57,990
2. Anchorage, Alaska — $54,738
3. Albany, Ga. — $49,874
4. MSA name withheld to protect confidentiality of the entities that contributed private data — $45,491
5. Santa Barbara-Santa Monica-Goleta, Calif. — $42,976
Here are the five metro areas identified by the GAO that have highest spending on coronary stent placement episodes.
1. Salinas, Calif. — $60,375
2. Albany, Ga. — $45,204
3. MSA name withheld to protect confidentiality of the entities that contributed private data — $44,470
4. MSA name withheld to protect confidentiality of the entities that contributed private data — $43,824
5. Asheville, N.C. — $43,578
The report's findings were based on the average insurance payouts for the three procedures from data reported in 2009 and 2010.
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