Variation

RECENT POSTS

How Much Would You Rather Pay For That Procedure? $170,000 or $43,000?

(Getty Images)

(Getty Images)

It’s nearly unbelievable to average consumers, but well known to wonks: health care prices are impossible to come by. Even calling and asking about a specific procedure, as researchers recently reported, led to an “I dunno” from the hospital itself more than half the time.

But now, a little bit of light is being shed on this dark area of health care. Wednesday morning, the federal government released a massive amount of data: the prices that hospitals across the country charge for 100 of the most common inpatient treatments.

Skipping over the wonk for now, let’s dive in to some numbers right here in the Bay Area. They cast a spotlight on how random and wildly variable health care prices are.

I picked one procedure, a hip or knee replacement (“lower extremity major joint replacement”) without major complications.

A joint replacement is generally a procedure you would schedule in advance, not a race-to-the-hospital-life-or-death-spare-no-cost situation. You might think the range of prices would be somewhat narrow.

You would be wrong. Continue reading

How one health system persuaded its doctors to change. Hint: It wasn’t easy.

Women who received an "adhesion barrier" after a cesarian section had no better outcomes. (Brett Neilson: Flickr)

Women who received an "adhesion barrier" after a cesarian section had no better outcomes. (Brett Neilson: Flickr)

By: Emily Bazar

The Banner Health system, which stretches from Alaska to Arizona, delivers about 30,000 babies a year, about a third by cesarean section.

When Banner officials scoured their data, they found wildly different patterns in how those C-sections were performed.

That was the easy part. Getting doctors to change their behavior proved more challenging.

“We realized just asking them was not going to cut it,” said Ken Welch, chief medical officer of Banner Estrella Medical Center in Phoenix.

We described Banner’s efforts to rein in variation in a recent USA TODAYBut we didn’t get into the nitty gritty of how the system convinced doctors to change. It’s an object lesson in the difficulty of getting doctors to change, but also the lengths to which health systems and insurers will go these days to make it happen.

Let’s start from the beginning. In its data analysis, Banner found striking differences in the use of pieces of film or fabric — called adhesion barriers — during C-sections. Some hospitals used the barriers during 79 percent of C-sections, while others used them less than 1 percent of the time.

Continue reading