I wrote a post on my other blog about the wildly varying costs of a hip implant and the difficulty of getting a cost estimate before choosing a hospital for surgery.. Now an article in the Dallas Morning News says medical costs in general at Dallas hospitals seem to have no consistency — some procedures cost five times as much at one hospital compared with another.
It’s almost impossible for a consumer to know where to go in order to get a reasonable price for a medical procedure. Here are excerpts from the article:
Some Dallas hospitals charge five times as much as hospitals just a few miles away for the same treatments, federal data shows.
In 2011, Medical City Dallas Hospital charged $430,219 for Medicare respiratory patients using a ventilator for more than four days. Baylor Medical Center in Irving, meanwhile, charged an average of $82,185 for the same treatment.
Las Colinas Medical Center charged Medicare an average of $160,832 for leg joint replacements, while Methodist Dallas Medical Center charged $34,148.
The hospitals say such charges don’t reflect what insurers and patients actually pay for medical care, which is usually much less.
Medicare reimbursed the hospitals for only a fraction of what they charged. Medical City, for instance, got back an average of $52,846 for its ventilator patients.
Still, federal health officials said, the data shows disparities that have no adequate explanation.
“There is no relationship we see in the variation in charges and the quality of care that’s being provided,” said Jonathan Blum, director of the Center for Medicare in the U.S. Department of Health and Human Services.
Patients usually don’t know what they or their health insurers are being charged for hospital treatments until the bills come in the mail, and those bills are usually hard to decipher.
HCA North Texas, the hospital group that includes both Medical City Dallas and Las Colinas, offers a website estimate of charges at http://hcanorthtexas.com/about/patient-pricing.dot, but those estimates depend on whether the patient is insured and then on which company provides the insurance.
“What patients pay has more to do with the type of coverage they have than charges,” Medical City Dallas Hospital said in a prepared statement.
“Government programs like Medicare and Medicaid determine how much they reimburse hospitals. Insurance plans negotiate their payments. Everyone else is eligible for our charity care program, or they receive Medical City’s uninsured discounts, which are similar to the discounts a private insurance plan gets.”
This approach to pricing makes hospitals very different from most businesses, which compete on price as well as quality and timeliness. As medical bills have climbed over the last decade, major employers have been pushing insurers and hospitals for more cost transparency. But both companies and consumers haven’t had much luck with comparison pricing for health care.
Texas Health Resources and Baylor Health Care System, the largest nonprofit hospital chains in the area, charged rates that were more comparable than the charges submitted by HCA Texas, which is a for-profit chain.
In leg joint replacements, Texas Health hospitals charged more than Baylor. For simple pneumonia, Baylor charged more than Texas Health.
“Baylor reviews its pricing policies and pricing levels every year to assure that they are reasonable compared to local and national competitors,” Baylor Health Care Systems said in a statement. “Further, Baylor also engages a third-party firm periodically to review the reasonableness of our prices.”
By far the highest charges in the area were at Medical City Dallas. The hospital charged Medicare an average of $480,540 each for 13 patients suffering from life-threatening infections that persisted for more than four days. It charged an average of $305,442 each for 25 patients with major bowel surgery that had significant complications.
The complete set of hospital charge data can be seen by going to cms.gov, clicking on “Research, Statistics, Data and Systems” and then “Medicare Provider Charge Data” under “Statistics, Trends & Reports.”