Most consumers will do comparison shopping when it comes to purchasing a car, major appliance or gasoline. Comparing hospital costs, however, can be a risky venture, experts say.In May the Centers for Medicare & Medicaid Services (CMS) released data comparing common procedures at hospitals throughout the nation. The data was compiled from hospital claims provided in connection with the top 100 patient stays billed to Medicare by approximately 3,400 hospitals.“The data show significant variation in charges from hospital to hospital including those within the same community for inpatient services,” the Department of Health and Human Services (HHS) said in a press release. “Hospitals determine what they will charge for items and services provided to patients and these charges are the amount the hospital bills.”As an example, HHS said nationally, the average cost for major joint replacement is $50,116. It's lowest, at $5,300, in Ada, Okla., and highest at $223,000 in Monterey Park, Calif. The average cost in central Indiana ranges between $42,000 and $51,000.
A number of factors influence the price of health care. Consumer advocacy not-for-profit group Common Cause Indiana has been working since 2009 on a hospital accountability study, said policy director Julia Vaughn.
“We’re trying to get the not-for-profit hospitals to report the number of charity cases and how much financial assistance they’re providing to patients,” she said. Charity can have a significant impact on pricing, Vaughn said.
Vaughn cautioned consumers about using the CMS report as a guide for selecting health care options. It's not all about how much a procedure costs, she said.“For the consumer, the available tools should address the cost and quality of care,” Vaughn said. “We need to worry about the quality of the care. We haven’t developed a correlation between cost and quality.”
The Indiana State Board of Health issues an annual Medical Errors Report, which compiles data submitted by all hospitals. It examines a number of areas that deal with quality of care, such as incidents of bed sores, foreign objects left in a patient, patient falls and number of cases that result in infection.Vaughn said when a consumer is looking for health care they should consider the number of procedures performed at a hospital and the percentage of people who develop complications. The data only paints part of the picture, she said.“The federal government is trying to put the consumer in the driver’s seat,” she said.She said the comparison of hospital costs has been discussed for the past 25 years and the nation is a long way from a point where accurate comparisons can be made from one provider to another. The problem remains that there is no easy way for consumers to gather data on cost, number of procedures and success rates of various providers.