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Meaningful Health Care Informatics Blog

May 14 2013   10:05PM GMT

Hospital charge data shows significant gaps



Posted by: RedaChouffani
charges, hospital charges

Earlier this month CMS released hospital-specific charge data for the 100 most frequent discharge codes at more than 3,000 U.S. hospitals. The information has been made available and hospitals have been reviewing the data closely to identify how they rank against other institutes.

The same information has interested many patients who are looking to identify a measurable way to compare prices on certain procedures. In the current health system, procedure costs are not consistent across hospitals. This makes it challenging for patients to see how some hospitals rank against others.

With the publication of this data, and some of the other data released as part of the Open Data Initiative, patients can begin to see summary data (though it’s limited to CMS payments and doesn’t include some commercial payers).

There are a number of procedures that vary in cost significantly from location to location. Joint replacement procedures in one of Oklahoma’s hospitals averages $5,304, while the same procedure in one California facility costs in the $223,373 range.

There are other large gaps in pricing, which further explains the frustration that some patients have with the health system. There has been interests in some of the other available payment models, some of which have been proposed by CMS under the payments to ACOs. Others have been offered by individual hospitals for a fixed fee for various procedures. These new payment models aim to reduce overall costs, encourage health systems to review their fees, and simplify the fee schedule for their patients.

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