One hospital charges $8,000 — another, $38,000

Washington Post ^ | May 8, 2013 | Sarah Kliff

[JerseyanExile]

Consumers on Wednesday will finally get some answers about one of modern life’s most persistent mysteries: how much medical care actually costs.

For the first time, the federal government will release the prices that hospitals charge for the 100 most common inpatient procedures. Until now, these charges have been closely held by facilities that see a competitive advantage in shielding their fees from competitors. What the numbers reveal is a health-care system with tremendous, seemingly random variation in the costs of services.

In the District, George Washington University’s average bill for a patient on a ventilator was $115,000, while Providence Hospital’s average charge for the same service was just under $53,000. For a lower joint replacement, George Washington University charged almost $69,000 compared with Sibley Memorial Hospital’s average of just under $30,000.

Virginia’s highest average rate for a lower limb replacement was at CJW Medical Center in Richmond, more than $117,000, compared with Winchester Medical Center charging $25,600 per procedure. CJW charged more than $38,000 for esophagitis and gastrointestinal conditions, while Carilion Tazewell Community Hospital averaged $8,100 in those cases.

Maryland has a unique system for hospital rate charges, so differences were smaller, and its average rate was lower than that of any other state in the most common procedures reviewed by The Washington Post. The highest average charge for a lower joint replacement was $36,000 by University of Maryland Medical Center in Baltimore, much lower than the highest rates in other states.

Elsewhere, Las Colinas Medical Center just outside Dallas billed Medicare, on average, $160,832 for lower joint replacements.

Five miles away and on the same street, Baylor Medical Center in Irving, Tex., billed the government an average fee of $42,632.

[txrefugee]

These outrageous differences in cost for the same procedures show that some thieves wear surgical masks. And it’s our money they are stealing. When is someone going to jail for this felony theft?

[The_Victor]

I wonder which hospital deals with more non-paying “customers?”

[buckalfa]

Capitalism and the market in play. Whatever the market will bear given that many hospital markets do not have competition.

[Rightwing Conspiratr1]

Federal reimbursements are based on labor costs. Hospitals have little incentive to lower costs.

[DannyTN]

What a hospital bills and what medicare pays are two different things. What Medicare actually pays is usually a fraction of what is billed.

If the billing diagnostic and bill codes are the same Medicare will pay both hospitals the same amount. There is payment modifier between cities, so a hospital in a high cost of living city gets paid more than a rural hospital.

Nevertheless, I’m glad to see the government releasing comparative data. Now if they would just require providers to charge the same amount to all payers including insurance companies, we will be on the road to some sensible healthcare.

[DannyTN]

What a hospital bills and what medicare pays are two different things. What Medicare actually pays is usually a fraction of what is billed.

If the billing diagnostic and bill codes are the same Medicare will pay both hospitals the same amount. There is payment modifier between cities, so a hospital in a high cost of living city gets paid more than a rural hospital.

Nevertheless, I’m glad to see the government releasing comparative data. Now if they would just require providers to charge the same amount to all payers including insurance companies, we will be on the road to some sensible healthcare.

[Buckeye McFrog]

Wonder what that hospital Moochelle worked for was charging vs. the ones she was scaring the indigent patients away to?

[freeangel]

The ajc had a similar article on the cost of hip or knee replacements at different hospitals in the area—ranged from about $29,000 to $91,000. And, yes, the most expensive was the one that handles a ton of non insured/illegals in the areaa.

[Gaffer]

First thing I'd do in this case is confirm who is “in DC” and who is “outside DC”...my guess is the lower price is a DC public hospital or relationship like that and the higher price is where the hospital is not majorly funded by government

[goodnesswins]

So...if you get a knee replacement at the more expensive hospital, SOMEONE should be able to WRITE OFF as a GIFT the difference!

[etcb]

The medical industry is almost the only business where you do not have the opportunity to discover the price you will be charged until after the service is provided. It is somewhat akin to a fast food restaurant refusing to post their prices and presenting you a bill for $2000.00 after you have eaten your hamburger.

[wbill]

An excellent question.

I'd also ask abotu differences in care.

For instance, there are hospitals that you seek out, and there are hospitals to avoid.

[Sequoyah101]

The Feds have posted tremendously current data from 2011.

Good job.

http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/index.html

[CodeToad]

Wanna really get pissed about medical costs? Get into wholesale medical supplies and medicines. The markups are staggering.

[albie]

So the Post is saying Obamacare will fix this?

[tjd1454]

We recently learned first-hand about the outrageous costs of health care. My son was in an accident and hurt his back. He was transported to hospital and spent the afternoon & evening in the ER room before being discharged. He had a bunch of x-rays, was on a bed in the hall - no room, no meals were offered him. The only medication was (finally) a Tylenol. They gave him an "off the shelf" back support (not customized), and let him go.

There was a parade of doctors who came over and briefly talked with him, some gave him a cursory look over. Now I know why - they all submitted their "consulting fees"

The cost for basically sitting in the ER for the better part of a day? $10,000. And my son doesn't have insurance through his job. Fortunately he also doesn't have any assets so, as they say, "you can only squeeze so much blood from a turnip"

[driftdiver]

So the govt should mandate prices?

[0.E.O]

Capitalism and the market in play. Whatever the market will bear given that many hospital markets do not have competition.

Hardly capitalism. More like caveat emptor. Capitalism provides for the free flow of information to allow the consumer to make an intelligent choice. This information is kept from the consumer, and they don't even know the price until the bill is sent. This is rip-off, pure and simple.

[0.E.O]

And, yes, the most expensive was the one that handles a ton of non insured/illegals in the areaa.

So then it' a good thing that the prices became available so patients could avoid those hospitals that are out to rip them off.