A new study raises serious concerns about how much hospitals are charging
uninsured patients for routine procedures. Researchers with Washington
and Lee University and Johns Hopkins Bloomberg School of Public Health
found that some facilities charge patients more than 10 times the cost
of the procedures.
The researchers used Medicare data to identify the fifty U.S. hospitals
with the highest charge-to-cost ratios in 2012. They specifically compared
hospitals' “chargemasters,” which detail the prices for
specific procedures, with the
costs that Medicare would authorize for the medical care.
Overall, the hospitals on the list charged approximately ten times their
Medicare-allowable costs (the national average of 3.4). The markup at
one facility was a staggering 1,260 percent. That means that if a surgery
costs $10,000 to perform, the hospital charges $126,000.
All but one of the facilities on the list is a for-profit hospital. While
40 percent of the hospitals are located in Florida, two in California
also made the list. Doctors Hospital of Manteca ranked 29th, while Doctors
Medical Center in Modesto ranked 30th.
As the researchers highlight, most public and private health insurers do
not use hospital charges to set their payment rates. However, uninsured
patients are commonly asked to pay the full charges, and out-of-network
patients and casualty and workers’ compensation insurers are often
expected to pay a large portion of the full charges.
"There are no market forces and no regulatory forces that keep the
prices down," Gerard Anderson, a professor in health policy and management
at Johns Hopkins Bloomberg School of Public Health and the study’s
told CBS MoneyWatch. "Nobody is telling them that they can't. [The compiled information]
hasn't been publicly available. They haven't been shamed."
The study findings appear in in the journal Health Affairs.
If you or someone you love has suffered from medical fraud or negligence,
don’t hesitate to
contacta San Diego medical malpractice attorney at the Law Offices of Robert Vaage for a free consultation.