March 24th 2025.
The first-ever report from the New York City Health Department was released on March 14th, with the purpose of tackling the issue of exorbitant hospital prices that patients are faced with. However, this report is missing crucial information due to the refusal of Anthem Blue Cross to share records.
According to The New York Post, the 263-page report, published by the newly established Office of Healthcare Accountability, has significant gaps because of Anthem's unwillingness to provide essential data. This includes the total costs of healthcare services offered by hospitals, which is crucial in determining whether their high prices are justified.
The study focused specifically on payments made through the city's health provider, Anthem Blue Cross, rather than private-sector insurance plans. Despite the fact that the city pays Anthem a staggering $3 billion annually to cover around 900,000 employees, the insurer has refused to share the necessary records.
The report revealed that in the last fiscal year, the city's GHI-Comprehensive Benefits Plan, which is managed by Anthem, paid an average of $45,150 for inpatient services across the top 10 hospital systems in New York. Among these, New York-Presbyterian and Montefiore Medical Center had the highest costs for full inpatient treatment, while Stony Brook University Hospital had the lowest at $36,876.
The prices for specific procedures showed significant variations, with colonoscopies ranging from $940 to $12,000 and cesarean-section deliveries costing anywhere between $7,000 and $58,000. Additionally, the city is now spending more on outpatient care than on inpatient services.
Anthem has claimed that releasing certain pricing data would breach confidentiality agreements with hospitals that were established before a 2021 federal rule mandated hospitals to disclose their prices publicly. However, Councilwoman Julie Menin, who sponsored the 2023 legislation that led to the creation of the city's first healthcare watchdog office, remains unconvinced.
With the city's health care insurance contract set to expire later this year, Menin emphasized the need for complete transparency in pricing from whichever insurer is chosen. "The city must require full disclosure of pricing," she stated firmly.
Menin also expressed her distress at the high prices revealed in the report, stating that they are "extremely high" and "sickening and unsustainable." She believes that this reiterates the need for price transparency in the healthcare sector. "Why should New York City be paying so much for health care?" she questioned.
In other news, Anthem has announced plans to add 250 jobs to its downtown St. Louis office.
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