Need a hip replaced? You might want to do some research before booking an operating room. This Wednesday, the Department of Health and Human Services released a report disclosing the costs of certain medical procedures in hospitals throughout the country. The federal list shows a vast difference in price from hospital to hospital for the same medical procedures. Some facilities are listed as charging up t0 40 times what other facilities charge.
The report showed a joint replacement costing $5,300 in Oklahoma and a whopping $223,000 in California. The range in prices is not limited to national or regional hospital systems, but even those within the same city showed extreme differences. Within the city of Jackson, Mississippi, heart failure treatments range from $9,000 to$51,000. That’s more than a 500% difference.
Usually patients with Medicare, Medicaid, or private insurance don’t feel these charges because their insurance companies will pay for the procedure at a lower cost. Medicare and Medicaid have their own price structure and insurance companies usually heavily negotiate costs. Patients without medical coverage or those who are having a procedure not covered by their insurance, are billed at these various rates and often have to negotiate with hospitals on their own behalf. Many, however, don’t know negotiating is an option and are stuck with egregious bills as a result.
Time Magazine Senior Editor, Jeffrey Kluger, explained the process on Weekends with Alex Witt. “When they decide to charge outside the Medicare structure, they rely on a double secret pricing menu call the Charge Master, and basically the prices they charge are just whimsical..” When asked if the report was shocking he noted, “I think the numbers surprise everyone. It’s been no secret that we’re grossly overcharged for these things.”
The list was formerly available for purchase for research purposes. This is the first time it has been made available at no cost to the public.