June 4—The Centers for Medicare & Medicaid Services (CMS) released estimates of average prices for 30 types of hospital outpatient procedures across the country as well as county-level data related to healthcare spending and utilization of services by Medicare beneficiaries. This is the first time CMS has released county-level data on Medicare spending and utilization.

The outpatient data include estimates of average prices for clinic visits, echocardiograms, endoscopies, magnetic resonance imaging (MRI) tests, cardiac imaging, eye tests, pulmonary tests, and other hospital outpatient procedures.

Last month, CMS posted price data for the 100 most common Medicare inpatient stays, noting that even within the same geographic area, hospital prices for similar services can vary significantly. Similarly, price data for the 30 hospital outpatient procedures show significant variations in price by geographic region. For example, an MRI and magnetic resonance angiography without contrast might have a price tag of $1,518.33 in Dubuque, Iowa, $2988.23 in Florence, S.C., $3,448.07 in Dothan, Ala., and $7258.24 in Lancaster, Pa. Level II eye tests and treatment might have a price tag of $119.58 in Madison, Wis., but a price of $352.33 in Round Rock, Texas, and a price of $719.37 in Philadelphia.

County-level data released by CMS included data on the prevalence of chronic conditions and multiple chronic conditions among Medicare beneficiaries as well as utilization of services and Medicare spending for these beneficiaries. The prevalence of conditions such as Alzheimer’s disease and dementia, chronic obstructive pulmonary disease, diabetes, asthma, cancer, and depression was studied. Additionally, the prevalence of multiple chronic conditions per beneficiary by county, as well as expenses related to treating these beneficiaries, was examined by year from 2007-2011.

According to CMS, both data sets will enable researchers, data innovators, and the public to better understand Medicare spending and service use, which could spur innovations while increasing transparency.  

Publication Date: Tuesday, June 04, 2013