Medical Negligence Attorneys Ask ‘Where Does The Money Go For Medical Procedures In Hospitals?’

O.R. in hospitalNew release of data collected by the Centers for Medicare & Medicaid Services (CMS) on the price of hospital charges from across the nation may make a few eyebrows go up. The data has never been easily accessible by the public but now as part of President Obama’s administrations efforts to make health care more affordable and accessible, it has now been released. This change to transparency in medical procedure pricing has revealed large discrepancies in what hospitals charge across the nation.

What The CMS Data Contains

The new report issued by CMS gives a breakdown of prices for common inpatient procedures performed at hospitals all across the country. The top 100 procedures are listed from over 3,000 hospitals that receive Medicare payments. The first report is from 2011 and can be accessed online at CMS.gov.

What will make those eyebrows go up is the difference in costs from one hospital to the next, with little rhyme or reason to it all. For example, one hospital charges $127,000 for a permanent pacer maker, yet another only charges $66,000 for the same procedure. A new lower limb could cost an average of $117,000 at one hospital yet only cost $25,600 somewhere else. The difference in charges does not seem to be geographic, just randomly more or less from one place to the next.

The report also lists the average actual payout for these procedures, which is interesting as well. One place may charge less for the procedure yet receives a larger average payout than another hospital that charges much more.  The payout is only a fraction of the billed charge, often less than 20% of the bill.

Need Surgery? Better Shop Around!

While many people never even notice these large charges as their insurance covers the majority of it, not all people are as lucky. These wacky prices that can vary tens of thousands of dollars per procedure are the actual prices charged to those without insurance. In addition, many types of health insurance only pay a percentage of the bill and leave the patient will the remaining balance.

The release of this data brings up more questions than it answers. How can there be such a large difference in billed costs and why are they seemingly so inflated at some hospitals? How is it fair to charge uninsured patient five to six times the amount of an insured patient?  The big question is, why even charge these escalated prices if no one is really expected to pay them?

The release of this data can only be a step in the right direction to transparency in medical charges and what consumers and taxpayers are actually paying for. Maybe all these raised eyebrows will get hospitals to rethink these ridiculous prices and come up with a more standardized way to bill for procedures.

Based in Chicago, IL Rosenfeld Injury Lawyers LLC is a select group of established trial attorneys who focus their practice on prosecuting personal injury and medical negligence cases involving the severely injured or killed.

http://www.washingtonpost.com/blogs/wonkblog/wp/2013/05/08/one-hospital-charges-8000-another-38000/

http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/index.html