As part of the Obama administration’s work to make our health care system more affordable and accountable, data are being released that show significant variation across the country and within communities in what hospitals charge for common inpatient services.The hope is that transparency will aid in informing the customers of the range of charges for the same services, so that they can ask appropriate questions before they sign on the dotted line.
I ran across articles from the LA Times and the NY Times in yesterday's Google news feed about this. The down loadable database on the CMMS webpage is searchable by city, state, procedure, etc. So, I searched Indianapolis. Then I pulled out the services where the range of charges were either at least two-fold, or the span was at least $25,000. That narrowed the 100 services to 20. Below is listed those 20, the hospitals that the CMMS database included as providing those services, and the average charge by each hospital. Due to the limited width capacity of this blog space, I also uploaded more detail on these services to Google Drive - that document also including the number of patients involved and the average total payment made to each hospital for each service. All numbers are from the CMMS database.
CMMS defines 'Average Covered Charges' as
The provider's average charge for services covered by Medicare for all discharges in the DRG [code for each service provided]. These will vary from hospital to hospital because of differences in hospital charge structures.I have highlighted in red, the highest charge and hospital doing so, for each service, and highlighted in blue, the lowest charge and the hospital doing so, for each service.
177 - RESPIRATORY INFECTIONS & INFLAMMATIONS W MCC
| INDIANA UNIVERSITY HEALTH | $ 64,552 |
| COMMUNITY HOSPITAL EAST | $ 30,309 |
| ST VINCENT HOSPITAL & HEALTH SERVICES | $ 51,553 |
| COMMUNITY HOSPITAL SOUTH | $ 32,157 |
| FRANCISCAN ST FRANCIS HEALTH - INDIANAPOLIS | $ 36,438 |
| COMMUNITY HOSPITAL NORTH | $ 25,793 |
189 - PULMONARY EDEMA & RESPIRATORY FAILURE
| INDIANA UNIVERSITY HEALTH | $ 34,705 |
| COMMUNITY HOSPITAL EAST | $ 18,772 |
| ST VINCENT HOSPITAL & HEALTH SERVICES | $ 36,482 |
| COMMUNITY HOSPITAL SOUTH | $ 23,818 |
| INDIANA HEART HOSPITAL THE | $ 19,000 |
| FRANCISCAN ST FRANCIS HEALTH - INDIANAPOLIS | $ 26,312 |
| COMMUNITY HOSPITAL NORTH | $ 25,489 |
190 - CHRONIC OBSTRUCTIVE PULMONARY DISEASE W MCC
| INDIANA UNIVERSITY HEALTH | $ 30,839 |
| COMMUNITY HOSPITAL EAST | $ 16,257 |
| ST VINCENT HOSPITAL & HEALTH SERVICES | $ 32,161 |
| COMMUNITY HOSPITAL SOUTH | $ 21,530 |
| WESTVIEW HOSPITAL | $ 27,874 |
| FRANCISCAN ST FRANCIS HEALTH - INDIANAPOLIS | $ 20,935 |
| COMMUNITY HOSPITAL NORTH | $ 19,830 |
194 - SIMPLE PNEUMONIA & PLEURISY W CC
| COMMUNITY HOSPITAL SOUTH | $ 15,490 |
| WESTVIEW HOSPITAL | $ 42,521 |
| FRANCISCAN ST FRANCIS HEALTH - INDIANAPOLIS | $ 22,203 |
| COMMUNITY HOSPITAL NORTH | $ 18,047 |
207 - RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT 96+ HOURS
| COMMUNITY HOSPITAL EAST | $ 90,280 |
| ST VINCENT HOSPITAL & HEALTH SERVICES | $113,156 |
| COMMUNITY HOSPITAL SOUTH | $ 93,587 |
| FRANCISCAN ST FRANCIS HEALTH - INDIANAPOLIS | $ 82,166 |
| COMMUNITY HOSPITAL NORTH | $104,773 |
252 - OTHER VASCULAR PROCEDURES W MCC
| COMMUNITY HOSPITAL EAST | $ 69,465 |
| ST VINCENT HOSPITAL & HEALTH SERVICES | $ 84,389 |
| INDIANA HEART HOSPITAL THE | $ 98,842 |
| FRANCISCAN ST FRANCIS HEALTH - INDIANAPOLIS | $ 80,402 |
253 - OTHER VASCULAR PROCEDURES W CC
| WILLIAM N WISHARD MEMORIAL HOSPITAL | $ 45,961 |
| INDIANA UNIVERSITY HEALTH | $ 67,222 |
| ST VINCENT HOSPITAL & HEALTH SERVICES | $ 63,087 |
| COMMUNITY HOSPITAL SOUTH | $ 42,018 |
| ST VINCENT HEART CENTER OF INDIANA LLC | $ 40,471 |
| INDIANA HEART HOSPITAL THE | $ 77,320 |
| FRANCISCAN ST FRANCIS HEALTH - INDIANAPOLIS | $ 48,518 |
280 - ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W MCC
| COMMUNITY HOSPITAL EAST | $ 34,695 |
| ST VINCENT HOSPITAL & HEALTH SERVICES | $ 44,761 |
| COMMUNITY HOSPITAL SOUTH | $ 26,938 |
| ST VINCENT HEART CENTER OF INDIANA LLC | $ 39,548 |
| INDIANA HEART HOSPITAL THE | $ 42,377 |
| FRANCISCAN ST FRANCIS HEALTH - INDIANAPOLIS | $ 40,149 |
| COMMUNITY HOSPITAL NORTH | $ 20,020 |
300 - PERIPHERAL VASCULAR DISORDERS W CC
| WILLIAM N WISHARD MEMORIAL HOSPITAL | $ 12,485 |
| INDIANA UNIVERSITY HEALTH | $ 25,701 |
| COMMUNITY HOSPITAL EAST | $ 16,125 |
| ST VINCENT HOSPITAL & HEALTH SERVICES | $ 29,451 |
| COMMUNITY HOSPITAL SOUTH | $ 16,517 |
| INDIANA HEART HOSPITAL THE | $ 13,131 |
| FRANCISCAN ST FRANCIS HEALTH - INDIANAPOLIS | $ 19,656 |
| COMMUNITY HOSPITAL NORTH | $ 15,930 |
329 - MAJOR SMALL & LARGE BOWEL PROCEDURES W MCC
| INDIANA UNIVERSITY HEALTH | $167,037 |
| COMMUNITY HOSPITAL EAST | $ 65,710 |
| ST VINCENT HOSPITAL & HEALTH SERVICES | $126,029 |
| COMMUNITY HOSPITAL SOUTH | $ 86,436 |
| COMMUNITY HOSPITAL NORTH | $ 77,510 |
377 - G.I. HEMORRHAGE W MCC
| WILLIAM N WISHARD MEMORIAL HOSPITAL | $ 28,754 |
| INDIANA UNIVERSITY HEALTH | $ 48,812 |
| COMMUNITY HOSPITAL EAST | $ 26,961 |
| ST VINCENT HOSPITAL & HEALTH SERVICES | $ 44,763 |
| COMMUNITY HOSPITAL SOUTH | $ 21,669 |
| FRANCISCAN ST FRANCIS HEALTH - INDIANAPOLIS | $ 27,230 |
| COMMUNITY HOSPITAL NORTH | $ 26,198 |
439 - DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC
| INDIANA UNIVERSITY HEALTH | $ 33,099 |
| ST VINCENT HOSPITAL & HEALTH SERVICES | $ 31,704 |
| COMMUNITY HOSPITAL SOUTH | $ 13,603 |
460 - SPINAL FUSION EXCEPT CERVICAL W/O MCC
| INDIANA UNIVERSITY HEALTH | $132,700 |
| COMMUNITY HOSPITAL EAST | $ 91,864 |
| ST VINCENT HOSPITAL & HEALTH SERVICES | $101,117 |
| COMMUNITY HOSPITAL SOUTH | $108,671 |
| INDIANA ORTHOPAEDIC HOSPITAL LLC | $ 52,680 |
| COMMUNITY HOSPITAL NORTH | $ 92,249 |
473 - CERVICAL SPINAL FUSION W/O CC/MCC
| INDIANA UNIVERSITY HEALTH | $ 79,326 |
| COMMUNITY HOSPITAL EAST | $ 60,270 |
| ST VINCENT HOSPITAL & HEALTH SERVICES | $ 57,482 |
| INDIANA ORTHOPAEDIC HOSPITAL LLC | $ 34,108 |
| COMMUNITY HOSPITAL NORTH | $ 55,374 |
480 - HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W MCC
| INDIANA UNIVERSITY HEALTH | $106,125 |
| ST VINCENT HOSPITAL & HEALTH SERVICES | $ 84,693 |
| COMMUNITY HOSPITAL NORTH | $ 56,874 |
698 - OTHER KIDNEY & URINARY TRACT DIAGNOSES W MCC
| INDIANA UNIVERSITY HEALTH | $ 52,815 |
| ST VINCENT HOSPITAL & HEALTH SERVICES | $ 37,306 |
| COMMUNITY HOSPITAL NORTH | $ 17,470 |
699 - OTHER KIDNEY & URINARY TRACT DIAGNOSES W CC
| INDIANA UNIVERSITY HEALTH | $ 34,708 |
| ST VINCENT HOSPITAL & HEALTH SERVICES | $ 29,710 |
| COMMUNITY HOSPITAL SOUTH | $ 14,748 |
| COMMUNITY HOSPITAL NORTH | $ 14,227 |
853 - INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE W MCC
| WILLIAM N WISHARD MEMORIAL HOSPITAL | $ 78,183 |
| INDIANA UNIVERSITY HEALTH | $176,566 |
| COMMUNITY HOSPITAL EAST | $ 89,746 |
| ST VINCENT HOSPITAL & HEALTH SERVICES | $128,228 |
| COMMUNITY HOSPITAL SOUTH | $ 94,702 |
| COMMUNITY HOSPITAL NORTH | $ 77,922 |
871 - SEPTICEMIA OR SEVERE SEPSIS W/O MV 96+ HOURS W MCC
| WILLIAM N WISHARD MEMORIAL HOSPITAL | $ 24,792 |
| INDIANA UNIVERSITY HEALTH | $ 54,135 |
| COMMUNITY HOSPITAL EAST | $ 33,402 |
| ST VINCENT HOSPITAL & HEALTH SERVICES | $ 45,947 |
| COMMUNITY HOSPITAL SOUTH | $ 30,444 |
| WESTVIEW HOSPITAL | $ 61,698 |
| FRANCISCAN ST FRANCIS HEALTH - INDIANAPOLIS | $ 39,768 |
| COMMUNITY HOSPITAL NORTH | $ 30,282 |
917 - POISONING & TOXIC EFFECTS OF DRUGS W MCC
| WILLIAM N WISHARD MEMORIAL HOSPITAL | $ 17,339 |
| INDIANA UNIVERSITY HEALTH | $ 36,401 |
| COMMUNITY HOSPITAL EAST | $ 20,535 |
| ST VINCENT HOSPITAL & HEALTH SERVICES | $ 32,138 |
| COMMUNITY HOSPITAL SOUTH | $ 15,835 |
| COMMUNITY HOSPITAL NORTH | $ 21,435 |
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3 comments:
How can hospitals in the same area, providing the same services have such a disparity? A difference of 100k for the same service...
There may be good reasons - or not. The point of putting out the data is so that folks ask.
I realize that there are many variables in an these costs; length of stay, age of the patient, severity of the condition etc. but we can see that in 10 of the 18 categories IU Health has the highest charges and in 13 of the 18 categories IU Health has the highest average total payments. When some of the average costs at IU Health are double the average of the lowest average cost at another provider I would ask more than a few questions.
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