Earlier this month CMS released hospital-specific charges data for more than 3,000 U.S. hospitals on the top 100 most frequent discharge codes click here. The information has been made available and hospitals have been reviewing the data closely to identify how they rank against other institutes.
The same information has also interested many patients who are actively looking to identify a measurable way to compare prices on certain procedures. In the current health system, procedure costs are not consistent across health systems. This makes it very challenging for patients to use those as methods to seek the actual cost or how some hospitals rank against others.
With the publication of this data, and some of the other data as part of the Open data initiative by the current administration, patients can begin to see summary data (also limited to CMS payments or not including commercial payers).
Based on the data released there are a number of procedures that vary in cost significantly from location to location. Joint replacement procedures in one of Oklahoma’s hospitals average $5,304 while the same procedure in the one of the facilities in California ranges in the $223,373
There are other similar large gaps in pricing, which further explains the frustration that some patients have with the health system. There have been interests in some of the other payment models available, some of which have been proposed by CMS under the payments to ACOs, or others offered by some hospitals for a fixed fee for some procedures. These new payment models that are starting to be used aim to reduce overall costs, encourage health systems to review their fees and simplify the fee schedule for their patients.