Prices for PCIs differ significantly in various parts of the U.S., according to a report released on July 16 from the Blue Cross Blue Shield Association. Within the same metropolitan area, costs varied by as much as 532 percent.
The report’s authors noted that approximately a million PCIs are performed each year at a cost of at least $10 billion.
They analyzed three years of data from independent Blue Cross and Blue Shield companies. They evaluated data from 86 of the largest 100 markets in the U.S. and included information on procedures performed in patients who did not have a heart attack.
Of the markets evaluated, approximately one-third had median episode costs for PCI that are at least 20 percent above the median of $27,144.
“These findings reinforce the importance of competition within a market and the need to provide consumers with effective tools to help them make informed decisions about their care,” they wrote.
The highest variation in costs within the U.S. markets were found in Los Angeles/Long Beach, Calif. (532 percent), Oakland, Calif. (504 percent), San Diego, Calif. (443 percent), Richmond/Petersburg, Va. (398 percent), and southwest Illinois (381 percent).
In those markets, between six and 33 facilities performed PCIs. The authors said there is typically greater cost variability in markets with more facilities, although they mentioned the report could not determine underlying factors that contribute to cost variation.
The lowest variation in costs were in Ventura, Calif. (13 percent), Grand Rapids/Muskegon, Mich. (17 percent), Colorado Springs, Colo. (21 percent), Albuquerque, N.M. (22 percent), and Jackson, Miss. (24 percent).
The highest median costs for PCIs were in Sacramento, Calif. ($61,231), southwest New Hampshire ($46,506), Wilmington/Newark, Del. ($46,272), Milwaukee/Waukesha, Wisc. ($44,164), and Madison, Wisc. ($42,211).
The lowest median costs were in Birmingham, Ala. ($15,494), Baltimore, Md. ($16,130), Louisville, Ky. ($16,313), Knoxville, Tenn. ($16,655), and southwest Maryland ($16,906).
“While progress has been made to reduce cardiac-related deaths in recent years, millions of Americans continue to need cardiac treatment and procedures,” Trent Haywood, MD, JD, chief medical officer for the Blue Cross Blue Shield Association, said in a news release. “Although some cardiac patients are not in a condition to shop for their procedure, the data show that many whose condition is less urgent have the ability to consider both quality and cost as they choose the best facility for their care.”