The Alice-in-Wonderland World of Hospital Billing in Atlanta
After the federal Centers for Medicare and Medicaid Services released pricing information on more than 3,000 hospitals across the country earlier this week, we decided we would do some local price comparisons. As WABE’s Jim Burress noted in his news story about the release of the pricing data, hospitals charge wildly divergent prices for common treatments or procedures (pneumonia, joint replacement, heart attack).
It’s one thing to say prices are wildly divergent, but it’s something else entirely to see the disparities laid out in a chart.
We’ve taken 11 of the most widely performed hospital treatments and compared the average charges for each of them from 14 major metro Atlanta hospitals. For these procedures, the variation in cost between hospitals averaged a whopping 352%.
In other words, the charge by the highest-priced hospital averaged more than 3 1/2 times the charge by the lowest-priced hospital for the same procedure. And that was the average — many were higher. For one specific procedure (treating respiratory infections), the difference between the lowest and highest hospital charge was a jaw-dropping 579%.
Again, these are Atlanta hospitals, all located within a 50-mile radius of Five Points.
Alphabetically, here are the 14 hospitals that we used in our comparison.
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ATLANTA MEDICAL CENTER |
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DEKALB MEDICAL CENTER |
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EMORY EASTSIDE MEDICAL CENTER |
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EMORY UNIVERSITY HOSPITAL |
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EMORY UNIVERSITY HOSPITAL MIDTOWN |
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GRADY MEMORIAL HOSPITAL |
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GWINNETT MEDICAL CENTER |
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HENRY MEDICAL CENTER, INC |
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NORTH FULTON REGIONAL HOSPITAL |
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NORTHSIDE HOSPITAL |
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PIEDMONT HOSPITAL |
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SAINT JOSEPH’S HOSPITAL OF ATLANTA, INC |
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SOUTHERN REGIONAL MEDICAL CENTER |
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WELLSTAR KENNESTONE HOSPITAL |
The graphs with comparisons by treatment or procedure can be seen in the slideshow above.
Some hospitals consistently had more expensive charges than their peers for these procedures. Others had lower prices. Here is the same list of hospitals ranked by how their prices overall compared with the rest of the hospitals in our study. These are arranged in order from the least expensive to the most expensive based on the hospital’s aggregate ranking from seven of the 11 procedures (using only those procedures for which we had data on all of the hospitals).
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At least for these procedures, DeKalb Medical Center has the lowest aggregate price ranking while North Fulton Regional Hospital has the highest aggregate price ranking.
We should note that these prices are based on each hospital’s internal pricing list, or chargemaster. One of the reasons prices vary so much is because each hospital accounts for its cost structure differently. But if asked, hospitals can’t explain how they arrive at any of these prices. As Kaiser Health News says, if you want to know how much a hospital charges, good luck.
Keep in mind that these are not the prices most people would pay. Medicare, Medicaid, and insurance companies all pay discounted prices for services that they have negotiated with the hospitals. If you have insurance, your bill would be considerably lower than the prices listed here.
But if you were uninsured and had to go to the hospital, these kinds of prices would be the starting point for your own negotiations with the hospital over your bill. And if a hospital loses money treating an indigent patient, this is the pricing they would use on their taxes to write off the loss.
In other words: these prices may not be written in stone, but they aren’t meaningless either.
The original data from the Centers for Medicare and Medicaid Services can be downloaded here.
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