Data being released for the first time by the government on Wednesday shows that hospitals charge Medicare
wildly differing amounts — sometimes 10 to 20 times what Medicare
typically reimburses — for the same procedure, raising questions about
how hospitals determine prices and why they differ so widely.
The data for 3,300 hospitals, released by the federal Centers for Medicare and Medicaid Services, shows wide variations not only regionally but among hospitals in the same area or city.
Government officials said that some of the variation might reflect the
fact that some patients were sicker or required longer hospitalization.
Nonetheless, the data is likely to intensify a long debate over the
methods that hospitals use to determine their charges.
Medicare does not actually pay the amount a hospital charges but instead
uses a system of standardized payments to reimburse hospitals for
treating specific conditions. Private insurers do not pay the full
charge either, but negotiate payments with hospitals for specific
treatments. Since many patients are covered by Medicare or have private
insurance, they are not directly affected by what hospitals charge.
Experts say it is likely that the people who can afford it least — those
with little or no insurance — are getting hit with extremely high
hospitals bills that may bear little connection to the cost of
treatment.
“If you’re uninsured, they’re going to ask you to pay,” said Gerard
Anderson, the director of the Johns Hopkins Center for Hospital Finance
and Management.
The debate over medical costs is growing louder, spurred partly by President Obama’s overhaul of the health insurance system.
Hospitals, in particular, have come under scrutiny for charges that are
widely viewed as difficult to comprehend, even for experts. “Our goal is
to make this information more transparent,” Jonathan Blum, the director
of the agency’s Center for Medicare, said in an interview.
No comments:
Post a Comment