Hospitals Forced to Reveal Their Most Privileged Information: The Cost of Care

Tuesday, May 14, 2013

The medical business is a typical business, extolling the virtues of free choice in the marketplace, while warning that the buyer must always beware (caveat emptor) and providing precious little data for the consumer to make an informed choice.

President Barack Obama’s Affordable Care Act, which will reshape the healthcare business when it rolls out next year, is already changing many of the ground rules and one of them is access to comparative data on medical procedures in different hospitals.

Last week, the Obama administration unveiled a database that lets consumers see the vast cost disparities, locally and nationally, between hospitals for common inpatient procedures. The database covers 3,300 U.S. hospitals and the top 100 procedures and treatments in 2011, but does not factor in quality of care.

Until now, the hunt for comparative healthcare cost and treatment information was not easy. The California Office of Statewide Health Planning and Development (OSHPD) has a website that allows for “common surgeries and charges comparison,” but its latest data is from 2009 and “physician charges are excluded.” The office also maintains a searchable database of average charges for common procedures, but it is an inefficient tool for comparing hospitals.    

The California HealthCare Foundation’s CalHospitalCare website lets consumers compare ratings on a range of issues for different maladies, including death rate, quality of care, length of stay and readmission rate. What it doesn’t compare is the cost of the procedure.

The California Public Interest Research Group (CalPIRG) released a report (pdf) in June 2012 that provided a comprehensive look at price disparities across the state, even breaking out costs at specific hospitals for knee replacements and cesarean sections. But it lacked the extensive database provided by the federal government last week.

Although the new federal database is extensive and illuminating, it still doesn’t show the true cost of treatment because of various discounts afforded those with insurance, especially through large employers. But it can be revealing for comparative purposes.

For instance, if you check into the Lompoc Valley Medical Center for treatment of simple pneumonia and pleurisy without complications, the average covered charges are listed at $10,653. That treatment is a little pricier at the Regional Medical Center of San Jose: $70,365.

Bronchitis and asthma treatment at Madera Community Hospital costs $13,294. At West Hills Hospital & Medical Center: $59,304.

Fresno Heart and Surgical Hospital will perform “major cardiovascular procedures” for $62,706. At Washington Hospital in Fremont, the average covered charges are $303,921, considerably cheaper than the next cheapest facility, John Muir Medical Center in Concord at $235,175.

A permanent pacemaker implant can be had at the University of California, San Diego Medical Center in Roseville for $41,023 or one can stop in at the John Muir Medical Center in Concord where the price is $166,839.      

The averaged covered cost of simple chest pain is $8,397 at Madera Community Hospital, compared to $79,147 at Doctors Medical Center in Modesto.

Major joint replacement or reattachment of a lower extremity is $32,022 at Los Angeles County Harbor-UCLA Medical Center in Torrance, compared to $223,373 at Monterey Park Hospital in Monterey Park.

All the treatments above assume there are no simultaneous afflictions or major complications beyond the bewildering medical bill that is still certain to follow.

–Ken Broder


To Learn More:

Medicare Charges Vary Widely at California Hospitals, New Data Show (by Chad Terhune, Los Angeles Times)

Medicare Provider Charge Data (Centers for Medicare & Medicaid Services)

Your Heart Attack Bill: $3,300 in Arkansas, $92,000 in California (by Chris Isidore, CNN Money)

Killer Hospital Rates: A New Tool Lets Patients Compare Prices (by Geoffrey Cowley, MSNBC)

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