New Hospital Data Show Giant Swings in Prices
Have a heart attack in Ogdensburg, New York, and it'll cost $15,087 on average. But if you are treated in Valley Regional Medical Center in Brownsville, TX., the bill will be nearly $66,000.
The federal government, for the first time, has published the prices charged by thousands of different U.S. hospitals, and the numbers confirm what health reform advocates have been screaming about for years: the charges vary enormously, and for seemingly unclear reasons.
What the Obama administration hopes is that publishing these prices will help force health care providers to be more consistent in their billing. It's called transparency, and experts say a lack of price information is one of the single biggest forces that has driven up health care costs in the United States.
"Hospital pricing is the craziest of crazy quilts. Prices are wildly different from one community to another; they are inexplicably and enormously different among hospitals in the same cities," says Ron Pollack, executive director of the consumer health organization Families USA.
"Most perniciously, uninsured people are the ones who usually pay the highest prices for their hospital care. It is absurd – and, indeed, unconscionable – that the people least capable of paying for their hospital care bear the largest, and often unaffordable, cost burdens."
The data uses billing information for the 100 most common hospital stays paid for by Medicare, from chronic obstructive pulmonary disease – mostly emphysema – to heart attacks, hip replacements and diabetes. The prices only cover Medicare, the federal health insurance plan for the elderly. Private insurers are often charged different prices, and people who pay cash are usually charged even more.
For treating acute myocardial infarctions -- heart attacks -- the costs ranged considerably, even within the same state. At Kingsbrook Jewish Medical Center in Brooklyn, NY, the average cost was $58,657, the data shows. Just across town, at Bellevue Hospital in Manhattan, the average was $38,514. Upstate at Crouse Hospital in Syracuse, NY, the cost was just $21,526.
Even in small states the cost varies widely. In South Carolina, Trident Regional Medical Center in North Charleston billed Medicare $59,059 on average to treat 26 heart attack cases in 2011. Aiken Regional Medical Center billed $36,895.
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"Currently, consumers don't know what a hospital is charging them or their insurance company for a given procedure, like a knee replacement, or how much of a price difference there is at different hospitals, even within the same city," Health and Human Services Secretary Kathleen Sebelius said in a statement. "This data and new data centers will help fill that gap."
The Centers for Medicare and Medicaid Services data show costs charges to treat a patient with heart failure ranged from $21,000 to $46,000 in Denver, Colo., and from $9,000 to of $51,000 in Jackson, Miss.
The nonprofit Robert Wood Johnson Foundation plans to publish a map based on the data, so people can choose where to be treated.
"Transformation of the health care delivery system cannot occur without greater price transparency," says the group's president, Dr. Risa Lavizzo-Mourey, "While more work lies ahead, the release of these hospital price data will allow us to shine a light on the often vast variations in hospital charges."