Medicare pays some hospitals double what it pays others for surgical complications

Complications after surgery are costly both to a patient's health but also to Medicare and the healthcare system as a whole. However, a recent study in JAMA Surgery found complications at some hospitals are more costly to Medicare than at others.

Researchers from Boston-based Brigham and Women's Hospital studied Medicare claims data for patients across the nation ages 65 to 100 who underwent one of four surgeries between 2009 and 2012: abdominal aortic aneurysm repair, colectomy for cancer, pulmonary resection or total hip replacement.

Researchers found wide hospital-to-hospital variation in Medicare payments for patients who survived complications after surgery.

They found that payments at the highest cost-of-rescue hospitals were two- to threefold higher than payments at the lowest cost-of rescue hospitals. By surgery, the gaps were:

  • Abdominal aortic aneurysm repair: $60,456 versus $23,261
  • Colectomy: $56,787 versus $22,853
  • Pulmonary resection: $63,117 versus $21,352
  • Total hip replacement: $41,356 versus $19,028

In addition to higher costs, hospitals with the highest cost-of-rescue also had higher risk-adjusted rates of serious complications when compared to the lowest cost-of-rescue hospitals, according to the study.

"This analysis suggests that steering patients away from these hospitals has the potential to both lower Medicare spending and improve the safety of surgical care for patients," the authors wrote.

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