Angioplasty costs in metro areas show huge gaps, report says

There is a wide disparity in what Medicare pays healthcare providers for the cost of an angioplasty, according to a new Health of America Report using Blue Cross and Blue Shield data.

At the top end, the highest median amount paid for the procedure is $61,231 in the Sacramento, California metropolitan area. On the other hand, the Birmingham, Alabama region books the lowest cost paid at $15,494.

However, the study found cost variations within the same region.

For instance, in Bakersfield, California, the median cost billed for an angioplasty is $18,153 compared to $38,579 in San Diego, $17,535 in Riverside- San Bernardino and $20,179 in Los Angeles-Long Beach.

[Also: Surgery charges for knee, hip vary widely across major markets]

Variations in cost within a market are significant, varying by as much as 532 percent, according to the report.

The analysis found these variations even after adjustments were made to reflect geographic differences.

"Further analysis indicates that there are other facilities in these same markets that deliver quality outcomes at a lower cost," the report states. "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."

The study highlights Medicare's efforts to use transparency to control costs. This is the second report of this type. An earlier study looked at the cost variation for knee and hip surgery.

The report analyzed cost variation for angioplasty at both inpatient and outpatient facilities in 86 of the 100 largest Metropolitan Statistical Areas in the United States. It focused on the procedure when used to clear the blocked arteries of patients who were not experiencing a heart attack.

Cardiovascular disease is a leading cause of death in the U.S. – responsible for one in four deaths each year – and is also one of the costliest to treat. Each year, an estimated one million angioplasties, with and without stents, are performed, making them a top contributor to healthcare costs, the report said.

Of the metropolitan areas evaluated, about a third have a median episode cost that is at least 20 percent above the national median of $27,144, according to the report.

Rounding out the top five for highest median costs are southwest New Hampshire, at $46,506; Wilmington-Newark, Delaware at $46,272; Milwaukee-Waukesha, Wisconsin, at $44,164; and Madison, Wisconsin, at $42,211.

The lowest median costs are found in Birmingham were found in Baltimore, at $16,130; Louisville, Kentucky, at $16,313; Knoxville, Tennessee at $16,655; and southwest Maryland, at $16,906.

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Complete data were unavailable for the states of New York, South Carolina, and Texas, and they were excluded from the study.

Montana, Wyoming, North Dakota, South Dakota, Vermont and Maine did not have any metropolitan areas in the top 100, and they were also excluded from the study.

The next step is understanding the reasons for the variation, resulting outcomes for patients, and the effect on the healthcare system as a whole, according to the report.

Here is the full breakdown of minimum, maximum and median costs for angioplasty billed in these top metro areas.

Twitter: @SusanMorseHFN