HHS and CMS provided data from calendar year 2011 on hospital-specific charges for the 30 most common ambulatory payment classifications, or APCs, for hospitals paid under Medicare’s outpatient prospective payment system. Many of the hospital outpatient department prices varied widely among hospitals, just as much as the inpatient charge data.
For example, Medicare routinely reimbursed similar amounts for outpatient debridement, or surgical removal of dead tissue, but charges were across the board. Nebraska Orthopaedic Hospital in Omaha charged $841.93 for the procedure, while St. John River District Hospital in East China Township, Mich., only charged $12.63.
Fawcett Memorial Hospital in Port Charlotte, Fla., charged almost $14,000 for a level III echocardiogram, a sonogram of the heart, compared with $678.24 at Logan (Utah) Regional Hospital.
Some within the industry believe the government’s efforts to shine light on healthcare prices will lead to hospitals updating chargemasters.
“Most hospitals are not-for-profit, and their boards are members of the community,” Bill Cleverley, president of healthcare analytics firm Cleverley + Associates, told Politico. “They don’t like to have their hospitals have extremely high prices relative to others because they think it reflects bad management.”
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