Dive Brief:
- A new report from the Blue Cross and Blue Shield Association (BCBSA) shows a huge variation in the amount providers are being paid for angioplasties, even within the same market.
- In Los Angeles alone, the median amount paid for an angioplasty was anywhere from $10,749 to $67,937, a variation of 532%.
- In Chicago, reimbursement for angioplasties ranged from $15,951 to $49,604, a variation of 211%.
Dive Insight:
This is the second report of its kind that BCBSA has released this year; the first showed pricing variations among hip and knee surgeries. Dr. Trent Haywood, chief medical officer of BCBSA, told Modern Healthcare that the report on angiplasty reimbursements didn't reveal a reason for the huge variations in payments, but he believes that the data was influenced by high-cost facilities. "The more transparency around this, the more that providers will start to address this particular issue," he said.
BCBSA intents to continue releasing these types of reports. Haywood told Modern Healthcare that doing so fits with the current shift in payment models that rewards lower-cost care and better outcomes. "This is in the context of all of us talking about how fee-for-service is not a sustainable model," he said.