A city agency created to tamp down skyrocketing hospital costs found that local health systems are charging a wide range of prices for their services, fueling the city’s health care affordability crisis.
The Office of Healthcare Accountability, a health-cost watchdog established under a city law passed in 2023, found that prices across local hospital systems are among the highest in the country and that costs of specific services such as colonoscopies and C-section deliveries vary from hospital to hospital, according to a 263-page analysis released on Friday.
The city paid an average of $45,150 for an inpatient admission at the top 10 health systems in the region, according to the report, based on claims from city health insurers Anthem Blue Cross Blue Shield and Emblem Health. The average cost varied widely between health systems: New York-Presbyterian led the pack, charging an average of $93,000 per visit, while Stony Brook Hospital in Suffolk County charged an average of about $37,000.
The city spent $11.5 billion on health care expenditures for its 1.2 million employees, retired workers and dependents during the 2024 fiscal year, according to the report. It spent $3.3 billion on hospital care, half of which went to three major hospital systems: Northwell, New York-Presbyterian and NYU Langone. The city spent $759 million at Northwell, $486 million at New York-Presbyterian and $444 million at NYU, according to the report.
The findings are hindered by gaps in data provided by the city’s largest insurer, Anthem Blue Cross Blue Shield, which refused to provide some medical claims information because the information is not public, according to the report. Though Anthem provided medical claims for the report, it did not submit information about how its reimbursement rates compared to what the government payer Medicare spends, sparking criticism from some elected officials and union leaders.
“Pieces of the report are missing critical data,” Manhattan Councilwoman Julie Menin, who sponsored the legislation establishing the Office of Healthcare Accountability, said during a city Health Department budget hearing on Monday. She said that the city cannot address rising health costs if “large swaths of this data is being redacted because Anthem is refusing to play ball.”
Kersha Cartwright, a spokeswoman for Anthem Blue Cross Blue Shield, acknowledged that the insurer did not directly submit information on how its payments compared to Medicare, but said that it posts such information publicly as required by federal price transparency rules.
Ken Raske, president of the Greater New York Hospital Association, which represents 200 hospital members including major city health systems, said in a statement that the report’s findings were “inadequate at best” because they do not consider differences in quality of care between hospitals that may drive price differences, nor that hospitals lose money on Medicare and Medicaid patients.
“No institution can survive with such underpayments for their services unless they can negotiate higher payments from private insurers to offset their losses,” Raske added.
Interim Health Commissioner Dr. Michele Morse said during the budget hearing that the Health Department was constrained by regulations that required them to use only public information, which does not include proprietary agreements between hospitals and insurers. But she defended the report’s findings.
“It’s very clear that New York City health care prices are higher than anywhere else in the country,” Morse said during testimony, adding that prices are varied across hospital systems despite quality.
“We do intend to follow the full letter of the law and make sure that the office actually does what it was intended to do,” Morse said.
The Office of Healthcare Accountability was established by a city law passed in 2023, which required the agency to analyze health expenditures for city employees and create a website to publicly post prices. The office has a $2 million budget, enough to cover 15 staff jobs. Only one full-time employee has been hired, however, and the city has seven other candidates in the pipeline, Morse said during the budget hearing Monday.
