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Thread: Hospital Price Disparities Made Public

  1. -1
    JamesBW43's Avatar
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    Hospital Price Disparities Made Public

    http://www.huffingtonpost.com/2013/0...n_3232678.html

    When a patient arrives at Bayonne Hospital Center in New Jersey requiring treatment for the respiratory ailment known as COPD, or chronic obstructive pulmonary disease, she faces an official price tag of $99,690.Less than 30 miles away in the Bronx, N.Y., the Lincoln Medical and Mental Health Center charges only $7,044 for the same treatment, according to a massive federal database of national health care costs made public on Wednesday.
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    Seems like there's more to this. If you're in at the Bayonne Hospital the total average payments is $5600 and $99,000 covered. At the Bronx medical center for same operation, average patient payment is $10,400 with $7000 covered.

    https://data.cms.gov/Medicare/Inpati...ider/97k6-zzx3
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    Re: Hospital Price Disparities Made Public

    This article is a bit confusing as they stated "treatment" for a given condition but never stated identical treatments. You could be treated for COPD with a $25 inhaler and a visit to urgent care for $50. However, if you get all the available treatments possible, running up $100K would be easy. The conclusion of the article doesn't hold water unless you compare apples to apples and then it only masters if you don't have insurance that is contracted with that specific hospital. A lot if hospitals inflate their charge masters not to overcharge indigent patients but to gather the greatest write-off when the indigent patient doesn't pay anything. I can assure you that far less than 1% of uninsured patients ever actually pay anywhere near 50% of billed charges. Usually, a 30% collection rate on charges billed to the patient, insured or otherwise, is considered excellent.
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    Really this is just outlining the difference in what's called the hospital's "chargemaster documents". It's the master document that holds all of the current charges for any service. From a $50 aspirin to a $10K knee surgery, and there is no rhyme or reason to what they charge. That's why most of the contracts I see at work are based on Medicare rates (110% of Medicare rates for commercial employer plans, etc.) The contracts I see that are based on billed charges are almost always low, like 60% of billed charges or lower.

    And to be honest, the discrepancies in the story don't surprise me one bit.
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    Quote Originally Posted by Buddy View Post
    This article is a bit confusing as they stated "treatment" for a given condition but never stated identical treatments. You could be treated for COPD with a $25 inhaler and a visit to urgent care for $50. However, if you get all the available treatments possible, running up $100K would be easy. The conclusion of the article doesn't hold water unless you compare apples to apples and then it only masters if you don't have insurance that is contracted with that specific hospital. A lot if hospitals inflate their charge masters not to overcharge indigent patients but to gather the greatest write-off when the indigent patient doesn't pay anything. I can assure you that far less than 1% of uninsured patients ever actually pay anywhere near 50% of billed charges. Usually, a 30% collection rate on charges billed to the patient, insured or otherwise, is considered excellent.
    True. And not sure why differences from many miles away used when you can point out the difference in the Bronx with Montefiore at 26,300 coverage/9,000 patient payement.

    The other 2 are more in line with Lincoln:

    Jacobi 10.7 covered/10.4 patient payments
    Lebanon 10/10.5
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    Re: Hospital Price Disparities Made Public

    Quote Originally Posted by Eshlemon View Post
    True. And not sure why differences from many miles away used when you can point out the difference in the Bronx with Montefiore at 26,300 coverage/9,000 patient payement.

    The other 2 are more in line with Lincoln:

    Jacobi 10.7 covered/10.4 patient payments
    Lebanon 10/10.5
    I still am unsure as to whether they are comparing identical DRG rates or courses of treatment. Regardless of what the charges are, the payment is very consistent by Medicare and Medicaid. The payments from the commercial insurers are fairly consistent as well and payments from uninsured people are extremely consent...typically hovering just above $0 as most of their charges are written off once they fail to collect.
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