Joint Replacement: $5,300 or $223,000

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June 6th, 2013

medical treatment costsThe Center for Medicare and Medicaid Services (CMS) recently released a report listing the hospital charges for 100 of the most common inpatient services and 30 common outpatient services for over 3,000 US hospitals. The report highlights the enormous variance in charges for the same procedure.

The data was released in an effort to promote price transparency in the US healthcare system and allow consumers to make comparisons between amounts charged by hospitals within local markets and nationwide. The “chargemaster” list of prices for each hospital are their prices dependent on a variety of factors like the location of the hospital, its size, the number of low-income patients it may serve, or if it is a teaching facility.  Insurance companies, Medicare and Medicaid all negotiate these rates and pay a percentage of these chargemaster rates.  The CMS also reported the amount that Medicare actually paid for those services, about 27% of the list price.

Where this reported information particularly comes into play is when considering uninsured individuals. Jonathan Blum, deputy administrator and director for the Center for Medicare said, “While the vast majority of patients in our country have public or private insurance there is a significant number of patients who are subject to these charges.” Releasing this information allows them to readily learn their local hospitals’ price list and at least become prepared.

The goal, however, of this release is said to better educate consumers of their options regardless of their insurance status.  This is a huge first step in improving price transparency in healthcare.

To view the CMS report please click here.