Eastern Iowa Hospitals Mirror National Results in Federal Pricing List
By Dave Franzman, Reporter
CEDAR RAPIDS, Iowa- If you wanted to know how much a medical procedure would cost beforehand, it was always a tough search. But the federal government’s release Wednesday of price information for hospitals nationwide will give consumers more sources of information. And like results nationwide, hospitals in eastern Iowa also show wide variation in “list” prices for what was billed to Medicare as the same medical procedure.
The Centers for Medicare and Medicaid, a part of Health and Human Services, released 2011 price information from 3,300 hospitals nationwide.
It’s a price list of the 100 most common hospital procedures. Government officials say if consumers know one hospital charges a lot more than another that information can go into a buying decision.
St. Luke’s and Mercy Medical Center in Cedar Rapids submitted “list price” bills to Medicare that track pretty closely for some services. But sometimes, one hospital or another would be thousands or tens of thousands of dollars apart for what appeared to be the same thing.
But Dr. Mark Valliere, Mercy chief medical officer, says the qualifying word is “appears.”
“These are average charges over a lot of different patients—so are we talking about elderly patients with many illnesses or is this somebody who only had one illness,” Dr. Valliere said.
Searching the list of 100 top procedures can produce some dramatic differences. For instance, one procedure listed as Respiratory Diagnosis with Ventilator Support showed Mercy submitted a bill to Medicare of $49,739.94. The hospital received reimbursement in the amount of $13,529.39. However, St. Luke’s billed the government $73,644.97 for the same listed procedure. Medicare paid $15,708.72 to St. Luke’s.
Milton Aunan, chief financial officer at St Luke’s, said just looking at the raw data isn’t a fair comparison.
“There could be additional complications they come across like in a surgical procedure that was not anticipated at admission time. Those things will result in additional charges,” Aunan said.
Neither Medicare, nor private insurance pays anywhere close to “list” price for medical services. So what people pay isn’t the same as they’d see on the price data list. Still, Dr. Valliere sees some value is looking at the list as a starting point.
“I think for somebody who is going to have a purely elective procedure with nothing out of the ordinary expected, it might be good guidance. But it won’t be perfect,” he said.
What's On KCRG