Price Variation in Orthopedic Procedures
Do you know the average price for planned knee and hip replacements in the communities where your employees live and work? Get a high-level understanding of the wide price variation that exists across the country.
Do you know the average price for planned knee and hip replacements in the communities where your employees live and work? Powered by our Blue Cross Blue Shield The Health of America report series, this infographic is designed to give you a high-level understanding of the wide price variation that exists across the country. A better understanding of these differences could mean significant cost savings for your organization and employees.
Data is from examining the medical claims of 49 million adult BCBS commercially insured members for cost and quality of care for planned knee and hip replacement procedures.
Prices for knee and hip replacements vary significantly by location. National average price for complete inpatient episode of care was $34,513 for knee surgeries and $34,282 for hip surgeries. Prices range threefold between metropolitan statistical areas (MSAs). Average inpatient knee prices in Des Moines Iowa were $19,934 while New York City's were $61,750. Des Moines' average inpatient hip prices were $19,263 while New York City's were $64,641.
Within the same MSA, there can be a significant difference in price. Price spread for planned knee replacements in the largest 100 MSAs ranged from $800 to $65,684. Price spread for planned hip replacements in the largest 100 MSAs ranged from $3,674 to $78,040. In 2017, Dallas had the greatest price spread for planned hip replacements, ranging from $20,597 to $98,638 for the same episode of care.
Key considerations: Do you know your organization's and employees' typical medical costs for knee and or hip procedures? Does your organization's typical medical costs vary within and between MSAs? If so, to what degree? Do you have cost transparency and provider finder tools to help employees identify higher quality, lower cost providers? How can you use your network and benefit design to guide and incentivize employees who are planning knee or hip procedures toward higher quality, lower cost providers?
We're here to help answer all your questions regarding cost control and orthopedic care. Visit smarterbetterhealthcare.com to contact you local BCBS company and to read the full ebook, "Controlling Cost as Orthopedic Procedures Rise."