Data outlines hospital charge disparities

By: Christy Dimond Email
By: Christy Dimond Email

GRAND JUNCTION, Colo. (KKCO) -- Recently released data from Medicare indicates a wide discrepancy in how much hospitals charge for the same procedures.

The report collected hospital-specific charges for the 100 most common procedures from 3,000 hospitals across the country.

Average charge for patient getting treated for pneumonia at Community Hospital is $12,720. At Saint Mary’s Hospital, the charge is $18,101, which is 42 percent more than Community Hospital charges. At Centura Health-Porter Adventist Hospital in Denver, the charge is $29,800.

The fluctuation can happen for a number of reasons. Hospitals aren’t required to use any specific formula to determine charges, so charges vary by facility.

“To be available 24 hours a week, seven days a week for anyone who walks in the door, can be expensive, as well as having highly specialized equipment,” said Debbie Riggle, VP of Ancillary Services at Community Hospital.

Dr. Michael Pramenko, Executive Director of Primary Care Partners, said the release of this data addresses a huge problem existing in the health care industry: patients not knowing the what they will be charged for procedures before they undergo the procedure.

“There’s no shopping going on in healthcare,” Dr. Pramenko said. “Reports like this really help pressure the industry to provide more data for the all the patients out there to help drive a change in the system.”

The report suggests patients must be their own advocate when navigating through health care. Pramenko suggested patients ask and continue to ask the cost of procedures.

Sometimes that answer will be a range of charges, depending on the procedure and each patient’s individual needs.

“A person with diabetes will have a little bit higher expense because they’ll have medications their neighbor didn’t have to have, so that’s when we would provide a range of charges,” Riggle said.

Health officials said the release of this data is a first step towards transparency in health care. By January of 2014, the Center for Improving Value in Health Care will have completed Colorado’s All Payer Claims Database, which will contain data on quality and cost information for every health care provider group in the state.

Click the link below for Medicare’s full report.


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