For the first time, data has been released that gives consumers information on what hospitals charge. Currently, consumers don’t know what a hospital is charging them or their insurance company for a given procedure, like a knee replacement, or how much of a price difference there is at different hospitals, even within the same city. The data will help fill this gap. The data reveals significant variation throughout the country and within communities in what hospitals charge for common inpatient services. The data is provided by the Health and Human Services (HHS) agency to increase health care cost transparency and accountability.
The data posted on CMS’s website includes information comparing the charges for services that may be provided during the 100 most common Medicare inpatient stays. Hospitals determine what they will charge for items and services provided to patients and these “charges” are the amount the hospital generally bills for an item or service.
These amounts can vary widely. For example, for services that may be provided in connection with a joint replacement, average inpatient charges range from a low of $5,300 at a hospital in Ada, OK, to a high of $223,000 at a hospital in Monterey Park, CA.
Even within the same geographic area, hospital charges for similar services can vary significantly. For example, average inpatient hospital charges for services that may be provided to treat heart failure range from $21,000 to $46,000 in Denver, CO, and from $9,000 to $51,000 in Jackson, MS.
To make this data useful to consumers, HHS is also providing funding to data centers to collect, analyze, and publish health pricing and medical claims reimbursement data. The data centers’ work helps consumers better understand the comparative price of procedures in a given region or for a specific health insurer or service setting. To view the report, please visit: http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/index.html