{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T07:56:27Z","timestamp":1793087787010,"version":"4.5.0"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The 2021 Price Transparency Rule was implemented to increase market competition, facilitate price shopping, and reduce prices and health care costs. We sought to measure inter\u2010 and intrahospital variation in prices, measure price variation across payer types, and identify hospital characteristics associated with increased commercial prices for 16 common cardiovascular admission diagnoses, diagnostic tests, and therapeutic procedures.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Prices were obtained from Turquoise Health, a platform that aggregates hospital prices from publicly available machine\u2010readable files, for each diagnosis, test, and procedure based on\n              <jats:italic>Current Procedural Terminology<\/jats:italic>\n              (\n              <jats:italic>CPT<\/jats:italic>\n              ) and\n              <jats:italic>Medicare Severity Diagnosis Related Group<\/jats:italic>\n              (\n              <jats:italic>DRG<\/jats:italic>\n              ) codes. Hospital characteristics were identified using\n              <jats:italic>Dartmouth Atlas<\/jats:italic>\n              data. Inter\u2010 and intrahospital price variations were measured using ratios. Multivariate linear mixed\u2010effects models were fit to determine the association between hospital characteristics and hospital\u2010level median commercial negotiated rates. We evaluated 1\u2009020\u2009349 unique rates across all diagnoses, tests, and procedures. The median (interquartile range) ratio of maximum to minimum commercial prices within hospitals ranged from 1.71 (1.14\u20132.53) for syncope and collapse to 3.1 (2.06\u20134.58) for cardiac valve surgery. Many hospital referral regions had 90th percentile commercial prices 2 to 3 times larger than 10th percentile commercial prices. Nonprofit status and high hospital market concentration were associated with increased commercial prices across all diagnoses, tests, and procedures.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">There is significant price variation for common cardiovascular admission diagnoses, tests, and procedures across and within hospitals as well as across payer types. Increased hospital market concentration is associated with increased commercial prices, so efforts to improve market competition alongside improving transparency compliance are warranted.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.124.038660","type":"journal-article","created":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T10:27:41Z","timestamp":1742207261000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Inter\u2010 and Intrahospital Price Variation for Common Cardiovascular Admission Diagnoses, Diagnostic Tests, and Therapeutic Procedures"],"prefix":"10.1161","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5569-6450","authenticated-orcid":false,"given":"Kriyana P.","family":"Reddy","sequence":"first","affiliation":[{"name":"University of Pennsylvania","place":["Philadelphia, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shreya","family":"Mehta","sequence":"additional","affiliation":[{"name":"University of Pennsylvania","place":["Philadelphia, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0879-7694","authenticated-orcid":false,"given":"Lauren A.","family":"Eberly","sequence":"additional","affiliation":[{"name":"University of Pennsylvania","place":["Philadelphia, USA"]},{"name":"University of Pennsylvania","place":["Philadelphia, USA"]},{"name":"University of Pennsylvania","place":["Philadelphia, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1345-3004","authenticated-orcid":false,"given":"Sameed Ahmed M.","family":"Khatana","sequence":"additional","affiliation":[{"name":"University of Pennsylvania","place":["Philadelphia, USA"]},{"name":"University of Pennsylvania","place":["Philadelphia, USA"]},{"name":"University of Pennsylvania","place":["Philadelphia, USA"]},{"name":"Corporal Michael J. Crescenz VA Medical Center","place":["Philadelphia, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6514-0405","authenticated-orcid":false,"given":"Paula","family":"Chatterjee","sequence":"additional","affiliation":[{"name":"University of Pennsylvania","place":["Philadelphia, USA"]},{"name":"University of Pennsylvania","place":["Philadelphia, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9060-5307","authenticated-orcid":false,"given":"Alexander C.","family":"Fanaroff","sequence":"additional","affiliation":[{"name":"University of Pennsylvania","place":["Philadelphia, USA"]},{"name":"University of Pennsylvania","place":["Philadelphia, USA"]},{"name":"University of Pennsylvania","place":["Philadelphia, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7374-4292","authenticated-orcid":false,"given":"Peter W.","family":"Groeneveld","sequence":"additional","affiliation":[{"name":"University of Pennsylvania","place":["Philadelphia, USA"]},{"name":"University of Pennsylvania","place":["Philadelphia, USA"]},{"name":"Corporal Michael J. Crescenz VA Medical Center","place":["Philadelphia, USA"]},{"name":"University of Pennsylvania","place":["Philadelphia, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8076-0098","authenticated-orcid":false,"given":"Jay","family":"Giri","sequence":"additional","affiliation":[{"name":"University of Pennsylvania","place":["Philadelphia, USA"]},{"name":"University of Pennsylvania","place":["Philadelphia, USA"]},{"name":"University of Pennsylvania","place":["Philadelphia, USA"]},{"name":"Corporal Michael J. Crescenz VA Medical Center","place":["Philadelphia, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7227-6423","authenticated-orcid":false,"given":"Ashwin S.","family":"Nathan","sequence":"additional","affiliation":[{"name":"University of Pennsylvania","place":["Philadelphia, USA"]},{"name":"University of Pennsylvania","place":["Philadelphia, USA"]},{"name":"University of Pennsylvania","place":["Philadelphia, USA"]},{"name":"Corporal Michael J. Crescenz VA Medical Center","place":["Philadelphia, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,3,17]]},"reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001052"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e31820a55f5"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2023.01.002"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","unstructured":"The role of prices in excess US health spending. Health Affairs2022. Accessed March 6 2024. doi: 10.1377\/hpb20220506.381195\/full\/.","DOI":"10.1377\/hpb20220506.381195\/full\/"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.120.017793"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2021.05.010"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamahealthforum.2021.0316"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/amajethics.2022.1069"},{"key":"e_1_3_1_10_2","unstructured":"Centers for Medicare & Medicaid Services . Hospital Price Transparency. Accessed March 6 2024. https:\/\/www.cms.gov\/priorities\/key\u2010initiatives\/hospital\u2010price\u2010transparency\/hospitals#key\u2010provisions."},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2021211948"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.8535"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaophthalmol.2021.3951"},{"key":"e_1_3_1_14_2","unstructured":"Turquoise Health . For patients. Accessed February 13 2024. https:\/\/turquoise.health\/patients."},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2022.08.071"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.40526"},{"key":"e_1_3_1_17_2","unstructured":"Turquoise Health . User guide: rate sense. Accessed February 14 2023. https:\/\/turquoisehealth.zendesk.com\/hc\/en\u2010us\/articles\/16689153417627\u2010User\u2010Guide\u2010Rate\u2010Sense."},{"key":"e_1_3_1_18_2","unstructured":"Dartmouth Atlas . FAQ. Accessed June 28 2024. https:\/\/www.dartmouthatlas.org\/faq\/."},{"key":"e_1_3_1_19_2","unstructured":"U.S. Census Bureau . Census bureau regions and divisions with state FIPS codes. Accessed February 13 2024. https:\/\/www2.census.gov\/geo\/pdfs\/maps\u2010data\/maps\/reference\/us_regdiv.pdf."},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.122.028032"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-021-06292-9"},{"key":"e_1_3_1_22_2","unstructured":"Health Care Cost Institute . Healthy Marketplace Institute. 2023. Accessed December 20 2023. https:\/\/healthcostinstitute.org\/hcci\u2010originals\/hmi\u2010interactive#HMI\u2010Summary\u2010Report\u2010Current\u2010Spending."},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000001391"},{"key":"e_1_3_1_24_2","doi-asserted-by":"publisher","DOI":"10.1177\/1355819614546032"},{"key":"e_1_3_1_25_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2017.2158"},{"key":"e_1_3_1_26_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-6773.2004.00235.x"},{"key":"e_1_3_1_27_2","doi-asserted-by":"publisher","DOI":"10.1093\/qje\/qjy020"},{"key":"e_1_3_1_28_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.49581"},{"key":"e_1_3_1_29_2","doi-asserted-by":"publisher","DOI":"10.2196\/50381"},{"key":"e_1_3_1_30_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamahealthforum.2023.3663"},{"key":"e_1_3_1_31_2","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.6792"},{"key":"e_1_3_1_32_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.123.031982"},{"key":"e_1_3_1_33_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2021.2531"},{"key":"e_1_3_1_34_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.5363"},{"key":"e_1_3_1_35_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-021-07237-y"},{"key":"e_1_3_1_36_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.37566"},{"key":"e_1_3_1_37_2","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2016.1471"},{"key":"e_1_3_1_38_2","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2015.0746"},{"key":"e_1_3_1_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2016.01.004"},{"key":"e_1_3_1_40_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.4288"},{"key":"e_1_3_1_41_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.1173"},{"key":"e_1_3_1_42_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamahealthforum.2021.0615"},{"key":"e_1_3_1_43_2","doi-asserted-by":"publisher","DOI":"10.1001\/virtualmentor.2012.14.11.oped1-1211"},{"key":"e_1_3_1_44_2","doi-asserted-by":"publisher","DOI":"10.1215\/03616878-3150160"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.124.038660","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T10:27:46Z","timestamp":1742207266000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.124.038660"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,17]]},"references-count":43,"alternative-id":["10.1161\/JAHA.124.038660"],"URL":"https:\/\/doi.org\/10.1161\/jaha.124.038660","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,17]]},"assertion":[{"value":"2024-11-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e038660"}}