Some hospitals charge vastly more for same care

Some hospitals charge vastly more for same care

Credit: Getty Images

Some hospitals charge vastly more for same care

Print
Email
|

by KING 5 News and CONNIE CASS and LAURAN NEERGAARD / Associated Press

KREM.com

Posted on May 8, 2013 at 2:44 PM

Hospitals across town and across the state sometimes charge thousands of dollars more for the same treatment, according to figures the government released publicly for the first time Wednesday.

The federal list sheds new light on the mystery of just how high a hospital bill might go -- and whether it's cheaper for uninsured patients to get the care somewhere else.

But it doesn't answer the big question: Why do some hospitals charge 20 or even 40 times more than others?

"It doesn't make sense," said Jonathan Blum, director of the government's Center for Medicare. The higher costs don't reflect better care, he said, and can't be explained by regional economic differences alone.

Blum said he hopes making the information available without charge to the public will help generate answers to the riddles of hospital pricing, and put pressure on the more expensive hospitals.

In Washington state, average covered charges for kidney and urinary tract infection treatment without major complications can range from almost $9,000 in average covered charges and more than $4,000 in average total payments at Wenatchee Valley Hospital, to more than $14,000 in average covered charges and almost $9,000 in average total payments at the University of Washington Medical Center, according to the U.S. Department of Health and Human Services.

Go to the bottom of this story for a breakdown of the most and least expensive hospitals in Washington state for five select medical procedures

The fees that Medicare pays hospitals aren't based on their charges, Blum said. But patients who are without government or private medical coverage are subject to them. The new information should help those patients decide where to get care, he said.

There are vast disparities nationally too. The average charges for joint replacement range from about $5,300 at an Ada, Okla., hospital to $223,000 in Monterey Park, Calif.

It's not just national or even regional geography. Hospitals within the same city also vary wildly.

In Seattle, average total payments for a major joint replacement or reattachment of a lower extremity without major complications are more than $21,000 at the UW Medical Center, but about $24,000 about Harborview Medical Center. Average charges covered at these hospitals are almost $32,000 and more than $67,000, respectively.

Hospitals usually receive less money than they charge, however. Their charges are akin to a car dealership's "list price." Most patients won't be hit with these bills, because they are paid by their private insurance, Medicare or Medicaid at lower rates. Insurance companies routinely negotiate discounted payments with hospitals.

"These charges really don't have a direct relationship with the price for the average person," said Chapin White of the nonprofit Center for Studying Health System Change. "I think the point is to shame hospitals."

The charges do show up on the bills of people without medical coverage, many of whom try to negotiate smaller fees for themselves. And they could affect people paying for care that is outside their insurance company's network. Hospitals say they frequently give the uninsured discounts.

"This is the opening bid in the hospital's attempt to get as much money as possible out of you," White said of the listed charges.

And some people pay full price, or try to afford it, because they don't know they can bargain for a discount, White said.

The department released a list of the average charges at 3,300 hospitals for each of the 100 most common Medicare inpatient services. The prices, from 2011, represent about 60 percent of Medicare inpatient cases.

"Hospitals that charge two or three times the going rate will rightfully face scrutiny," Health and Human Services Secretary Kathleen Sebelius told reporters.

And consumers will benefit from more information about a mystifying system that too often leaves them with little way of knowing what a hospital will charge or what their insurance companies are paying for treatments, Sebelius said.

Previously, the price information that the government collects from hospitals wasn't available to the average consumer, although the data could be purchased for uses such as research, officials said.

The department also is making $87 million in federal money available as grants to states to improve their hospital rate review programs and get more information about health care charges to patients.

Here's a look at the three least and most expensive hospitals in Washington to visit for some specific medical procedures:

Heart failure and shock with major complication or comorbidity
 

  • Walla Walla General Hospital, Walla Walla
    • Average charges covered: $28,433      
    • Average total payments: $8,441
  • Valley Hospital, Spokane
    • Average charges covered: $15,088    
    • Average total payments: $8,726
  • Overlake Hospital Medical Center, Bellevue
    • Average charges covered: $29,092      
    • Average total payments: $8,931
  • Virginia Mason Medical Center, Seattle
    • Average charges covered: $25,362
    • Average total payments: $12,473
  • Harborview Medical Center, Seattle
    • Average charges covered: $26,750    
    • Average total payments:  $14,543
  • University of Washington Medical Center, Seattle
    • Average charges covered: $32,578      
    • Average total payments: $17,000


Major small and large bowel procedures with major complication or comorbidity

  • Valley Hospital, Spokane
    • Average charges covered: $69,148      
    • Average total payments: $30,335
  • Olympic Medical Center, Port Angeles
    • Average charges covered: $59,823      
    • Average total payments: $33,784
  • Central Washington Hospital, Wenatchee
    • Average charges covered: $63,693    
    • Average total payments: $34,173
  • Harborview Medical Center, Seattle
    • Average charges covered: $92,937      
    • Average total payments: $48,426
  • PeaceHealth Southwest Medical Center, Vancouver
    • Average charges covered: $148,901      
    • Average total payments: $52,269
  • University of Washington Medical Center, Seattle
    • Average charges covered: $117,314      
    • Average total payments: $64,178


Major joint replacement or reattachment of lower extremity without major complication or comorbidity

 

  • Wenatchee Valley Hospital, Wenatchee
    • Average charges covered: $24,619      
    • Average total payments: $12,729
  • Walla Walla General Hospital, Walla Walla
    • Average charges covered: $43,434      
    • Average total payments: $13,113
  • Overlake Hospital Medical Center, Bellevue
    • Average charges covered: $45,672      
    • Average total payments: $13,444
  • Tacoma General Allenmore Hospital, Tacoma
    • Average charges covered: $86,022      
    • Average total payments: $17,369
  • University of Washington Medical Center, Seattle
    • Average charges covered: $31,753      
    • Average total payments: $21,521
  • Harborview Medical Center, Seattle
    • Average charges covered: $67,105      
    • Average total payments: $24,298


Kidney and urinary tract infections without major complication or comorbidity

  • Wenatchee Valley Hospital, Wenatchee
    • Average charges covered: $8,947      
    • Average total payments: $4,412
  • Valley Hospital, Spokane
    • Average charges covered: $13,797      
    • Average total payments: $4,702
  • Overlake Hospital Medical Center, Bellevue
    • Average charges covered: $15,184      
    • Average total payments: $4,728
  • Virginia Mason Medical Center, Seattle
    • Average charges covered: $10,924      
    • Average total payments: $6,434
  • Harborview Medical Center, Seattle
    • Average charges covered: $12,880    
    • Average total payments: $7,372
  • University of Washington Medical Center, Seattle
    • Average charges covered: $14,288    
    • Average total payments: $8,721


Septicemia or severe sepsis with major complication or comorbidity and continuous invasive mechanical ventilation for less than 96 consecutive hours

  • Northwest Hospital, Seattle
    • Average charges covered: $42,511      
    • Average total payments: $12,155
  • Providence St. Mary Medical Center, Walla Walla
    • Average charges covered: $31,129      
    • Average total payments: $12,553
  • Skagit Valley Hospital, Mount Vernon
    • Average charges covered: $41,058      
    • Average total payments: $13,160
  • St. Francis Community Hospital, Federal Way
    • Average charges covered: $58,956      
    • Average total payments: $13,628
  • Legacy Salmon Creek Medical Center, Vancouver
    • Average charges covered: $41,333      
    • Average total payments: $14,065
  • St. Anthony Hospital, Gig Harbor
    • Average charges covered: $52,010      
    • Average total payments: $13,690

Print
Email
|