Gov’t Reveals Hospital Charges to Medicare

AUDIO – 050913 – Medicare Publicizes Hospital Charges CVPH vs AMC pricing

For the first time, the government is publicly revealing how much hospitals charge, and the differences are astounding: Some bill tens of thousands of dollars more than others for the same treatment, even within the same city.

Medicare Deputy Administrator Jonathan Blum asks “Why does a joint replacement cost 40 times as much at one hospital as at another across the country? It’s a mystery.. It doesn’t make sense he says.. and the higher charges don’t reflect better care.. and he continues by saying The Discrepancies are too huge to be explained by obvious differences among hospitals, such as a more expensive regional economy, older or sicker patients, or the extra costs of running a teaching hospital.

The average charges for joint replacement range from about $5,300 at one Oklahoma hospital to $223,000 in Monterey Park, Calif. the Department of Health and Human Services says those numbers don’t include doctors’ fees.

At CVPH in Plattsburgh, the average billing for 136 joint replacement cases is $36,182. Medicare paid $17,411 on average to CVPH for those procedures… There were 66 cases of Major Joint Replacement at Adirondack Medical enter in Saranac Lake and the average Charges were $29,116 That’s 40% lower than the national average.. Further Medicare paid $14,522… That’s a difference of $2,889 per patient for similar procedures.

We speak with Chandler Ralph, President and CEO of Adirondack Health..

In Eleven of the 21 types of cases listed AMC reports billed amounts fifty percent or more lower than the national average. Medicare payments were half again on average lower than that..

Click here to view charges via a New York Times Interactive Pricing Map

Audio clip: Adobe Flash Player (version 9 or above) is required to play this audio clip. Download the latest version here. You also need to have JavaScript enabled in your browser.