Estimated read time: 3-4 minutes
This archived news story is available only for your personal, non-commercial use. Information in the story may be outdated or superseded by additional information. Reading or replaying the story in its archived form does not constitute a republication of the story.
SALT LAKE CITY — A report released Wednesday revealed medical charges for the same service can vary from one state to state, or even from one street to street.
The report, released by Centers for Medicare and Medicaid Services (CMS), didn't indicate a reason for varying costs for same procedures, and both the White House and patients want to know why.
"It is a question that I think consumers, justifiably, ask: 'Why is that hospital charging three times more for the same service that a hospital in the next town over may be charging?' " said White House Press Secretary Jay Carney in a press briefing.
The report compiled bills from more than 3,000 hospitals around the country and reveal a seemingly random variation in prices for 100 of the most common patient procedures.
It is a question that I think consumers, justifiably, ask why is that hospital charging three times more for the same service that a hospital in the next town over may be charging?
–Jay Carney
Bills for hip and knee replacements ranged from $5,300 in Ada, Okla., to $223,000 in Monterery Park, Calif. Heart attack procedures saw a similar variation in billed services. In Danville, Ark., it cost a little over $3,000, but in Modesto, Calf., it cost closer to $92,000.
The disparity isn't seen just from state to state — it exists even for hospitals a few miles apart.
In the nation's capital, George Washington University billed patients on a ventilator $115,000, while patients just down the street at Providence hospital were charged about $53,000.
Utah is no exception to varied costs from hospital to hospital. Where you get treated in the state can mean a big difference in the bill. Some hospitals charge double what other hospitals charge for services, like intestinal procedures and chest pain.
For example, getting a pacemaker costs around $38,000 at Utah Valley Medical Center in Utah County. That same procedure, just 43 miles north in the Salt Lake valley, could cost up to $75,000.
Robert Zirkelbach, spokesperson for America's Health Insurance Plans, said insurers like Medicare are able to negotiate lower fees to a degree. However, the more a hospital charges, the more a patient is likely to pay in insurance premiums.
Related:
Utah's first co-op health plan provider cleared by state
As the health care field continues to change, the state has given its approval to a new health care company that plans to bring innovative coverage to Utah. Arches Health Care was one of many organizations across the country that received federal loans in 2012 to establish a CO-OP, or a Consumer Operated and Oriented Health Plan."The data doesn't show that there's any (difference in) quality care as the prices go up," he said. "So much of the public policy debate is focused solely on health insurance premiums and has largely ignored the prices that are being charged for services that drive those premium increases," Zirkelbach said.
As the debate shifts to what hospitals are charging, the Utah Hospital Association said hospital charges are based on historical data and negotiated payments. Another big factor is uncompensated care. When a patient isn't able to pay the bill for treatment, charges reflect the gap to compensate for that loss in order to keep up with hospital hours.
The charges are a starting point for how much hospitals get paid. Depending on whether or not a patient is insured, they could be asked to pay full charges. However, the White House hopes the data on discrepancies will help better educate and empower patients.
"Today's data released by CMS is one step toward putting people and families in charge of their own health care," Carney said.
