What Hospitals Cost; What Insurers Pay
Comparing Two Hospitals in Miami, Florida:
Heart attack with four stents and major complications
| Average cost | $166,174 | $89,027 |
| Average reimbursement | $27,397 | $33,129 |
Intestine procedures with major complications
| Average cost | $248,105 | $185,927 |
| Average reimbursement | $44,794 | $73,455 |
Permanent pacemaker implant
| Average cost | $127,038 | $66,030 |
| Average reimbursement | $20,836 | $28,668 |
Source: The Washington Post.
This is interesting for a number of reasons.
I think that if or when the public has a reason to care about differences illustrated by data like these, prices will will converge – that is, the variance in present pricing will reduce by a lot. What would make the public care? Making the data public is one way, and will help. But I think individuals’ paying for some larger share of the bill is the surest way. That’s just my bias.
Also . . . notice that knowing a hospital’s charges does not necessarily tell you which one is “more expensive.”
In each case above, University Hospital’s charges are more than Jackson’s. However, in every case, Jackson actually realizes the higher reimbursement. That kind of distortion is also unlikely to survive the antiseptic sunshine of disclosure.
WOW!
The article quotes many more enormous disparities between hospitals in the same localities. Now that we finally have data on price, it would be interesting how this data correlates with measures of hospital quality.
Some people often associate cost with quality. OR The university hospital could receive more Medicaid/Medicare patients and are increasing the prices commensurate with repayment rates.
OMG, that is crazy. You will find the same thing happening across the nation. Compare any hospital to Baylor, and you will find that Baylor will always be way more expensive. This whole thing just doesn’t make sense to me!
This is what happens when there is no competition for consumers.
This is a big win. The actual government site mentions free-markets and price comparisons. All this from the guy who won an award for transparency at a ceremony that was not listed on the presidential itinerary and no reporters were invited.
For the Intestine procedures with major complications, the reimbursement difference is pretty big, what do you think might explain for this difference.
I think I rather go to India and have it all done under $20,000. I need to visit the mother land sometime soon anyways.
I wonder what it took to get these numbers, given that it is nearly impossible to get any price for any of the procedures in health care in general.
If I’m Miami for a golf tournament, and a medical emergency occurs, be sure and take me to the cheaper hospital, please.
@Tiger “take me to the cheaper hospital, please”
How will anyone know which one is “cheaper?
Well, Miami is a teaching hospital. Teaching hospitals are historically more expensive than their counterparts.
“After severity adjustment, teaching cases in aggregate were associated with an additional 4.4% of the total direct variable cost of inpatient admissions, or US 3.6 million dollars.”
http://www.ncbi.nlm.nih.gov/pubmed/15989911
Unless big donations let hospitals operate in the black by collecting less than 1/5 of their costs, it should be obvious that the quoted costs have nothing to do with anything. Except, perhaps, they aid in extracting the maximum from nonsensical government payment systems.
The private sector apparently operates from an entirely different set of prices that, one hopes, are more in line with actual costs.
Interestingly enough, Jackson Memorial is both a Level 1 trauma centre and a Safety Net hospital. U of Miami is neither. Interesting.
Quote from Blum: “ We’ll continue to pay claims, but our mission has also shifted to be a trusted source in the marketplace for information. We want to provide more clarity and transparency on charge data.”
To me this would justify being paid for outcomes not FFS. Jackson charged less and profited more. Interesting.
@Erik ” Jackson charged less and profited more”
No one knows if they profited more. All anyone knows from the data presented is that their net reimbursement was larger.
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