Report on Cost Variation Spotlights Knee, Hip Arthroplasty
The Health of America, a new report from the Blue Cross Blue Shield Association (BCBSA), found that the amounts charged by hospitals for hip- and knee-replacement surgeries in 64 US geographic markets vary wildly within and between markets.
The report focused on hip and knee replacements because those are among the fastest-growing medical interventions in the US. The report cited a June 4, 2014 JBJS study stating that between 1993 and 2009, primary knee replacements more than tripled, and primary hip replacements doubled.
The BCBSA report found that within-market cost variation for knee replacements exceeded $18,701 in 16 of the 64 markets analyzed. Twenty-two of the markets studied had a greater than $17,301 variation for hip replacements. The dubious distinction for highest variation within a market went to Boston, where there was a 313% gap between the lowest- and highest-priced hip replacement surgeries.
Overall, Montgomery, Alabama had the lowest average costs for knee and hip replacement surgeries (about $16,000 each), and New York City had the highest (about $60,000 each).
With ever-growing deductibles and other “cost-shifting” that increases out-of-pocket expenses for patients, it behooves individuals to talk to their doctor and their insurer, and to understand hospital charges as well as possible before agreeing to an elective procedure, orthopaedic or otherwise.