CMS: Hospital Outpatient Charges Vary Just as Much as Inpatient

This past May, HHS and CMS released a large dataset on the top 100 most frequently billed inpatient discharges at hospitals across the United States as part of their efforts to increase transparency, and the healthcare agencies have added to their efforts by releasing data on hospital outpatient charges.

HHSHHS 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.

CMSSome 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."

More Articles on Hospital Price Transparency:

10 Hospitals With the Highest Heart Attack Treatment Charges
Dr. Toby Cosgrove: Transparency in Healthcare is "The Right Thing to Do"
Moody's: CMS Price Transparency Report Has Long-Term Implications for Hospitals

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