The New York City Health Department released an inaugural report aimed at addressing the high prices hospitals charge patients, but the report has significant gaps due to the refusal of Anthem Blue Cross, the city’s largest public-employee insurer, to provide records. The report focused on payments made by the city’s health care provider, Anthem Blue Cross, rather than private-sector insurance plans. The report revealed that hospital prices are inconsistent, with an average payment of $45,150 for inpatient services at the top 10 hospital systems in New York City.
Among the hospital systems analyzed, New York-Presbyterian and Montefiore Medical Center had the highest prices for full inpatient treatment, while Stony Brook University Hospital had the lowest cost. The report highlighted that the city spent $3.3 billion on employee hospital care during the fiscal year, with half going to three hospital systems: Northwell Health, New York-Presbyterian, and NYU Langone Health. New York-Presbyterian had the highest prices for most procedures analyzed, both inpatient and outpatient.
Prices at hospital systems varied widely for common procedures, such as a colonoscopy and a cesarean-section delivery. The report noted that the city now spends more on hospital outpatient care than inpatient care. Anthem, the city’s health care insurance provider, refused to provide the Office of Healthcare Accountability with complete data on health care costs at hospitals, citing confidentiality agreements with hospitals that predate a federal rule requiring hospitals to disclose their prices to the public.
Councilwoman Julie Menin, who sponsored legislation creating the health care watchdog office, criticized Anthem for not complying with the city’s law requiring transparency in health care pricing. Menin emphasized the need for full transparency in health care pricing to avoid the city paying exorbitant costs for medical services. The city’s health care insurance contract is up for renewal later in the year, and Menin urged the city to require full disclosure of pricing from the selected provider. Anthem is among the bidders for the new contract.
The Office of Healthcare Accountability was established to provide greater transparency to patients on the costs of medical procedures at private hospitals versus city-run medical facilities. It has the authority to publicly release hospital pricing citywide and operates with a budget of $2 million and 15 staff members. District Council 37, the city’s largest municipal employee union, called for health insurance companies and hospitals to remove barriers to data access in order to achieve transparent and equitable pricing of medical services. Anthem representatives did not respond to requests for comment on the report and its findings.
