Community Health Systems, HCA respond to nationwide study on hospital markups

Two major for-profit hospital operators have responded to a national hospital billing study that used Medicare costs reports to find the 50 U.S. hospitals with the highest charge-to-cost ratios, or markups, in 2012.

The study, which was published in Health Affairs, found on average, hospital charges were 3.4 times the Medicare-allowable cost in 2012. Hospital operators have questioned the researchers' findings, saying the charge-to-cost ratios included in the study bear little relationship to what patients or government and private payers actually pay for medical services.

For the study, the researchers focused on those hospitals in the top 1 percent — 50 hospitals with charges that, on average, were 10 times their Medicare-allowable cost. Franklin, Tenn.-based Community Health Systems operates half of those 50 hospitals.  

"All hospitals are required to maintain a charge master, or a list of prices, for the numerous services they provide," Tomi Galin, a spokeswoman for Community Health Systems, told the Tampa Tribune. "However, these charges rarely reflect what consumers actually pay for their healthcare."

Nashville, Tenn.-based Hospital Corporation of America operates more than 25 percent of the 50 hospitals with the highest markups.

J.C. Sadler, a spokeswoman for HCA West Florida, told the Tampa Tribune, "The amount patients pay for hospital services has more to do with the type of coverage they have than the prices listed in the charge master." Concerning those without coverage, Ms. Sadler told the Tampa Tribune, "Uninsured patients are eligible for free care through our charity program or they receive our uninsured discount, which is similar to the discounts a private insurance plan gets."

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