What does an inpatient hospital procedure actually cost? That depends on the severity of patient illness, geographics, number of such services performed, status as a teaching hospital, and other factors. Even so, significant discrepancy exists among hospital costs for the same procedures.
Massachusetts has led the way with respect to transparency in hospital charges. Under Chapter 224, An Act Improving the Quality of Health Care and Reducing Costs through Increased Transparency, Efficiency and Innovation, the Commonwealth designated the Center for Health Information and Analysis as the responsible agency to maintain the consumer-friendly website http://hcqcc.hcf.state.ma.us/Default.aspx among other duties. The website provides useful data on hospital reduction of inpatient care errors, mortality rates, hospital recommended patient care, patient experience ratings, and hospital ratings. The website also contains information on other health care providers and costs paid by insurers to hospitals.
On a national level, the U.S. Department of Health and Human Services recently released data -- http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/index.html -- on rates charged by hospitals that receive Medicare reimbursement per patient discharge. The data identify hospital charges or charge master amounts based on a hundred common inpatient services for 2011, and the data also track Medicare reimbursement rates paid to hospitals for those services. In addition, the Centers for Medicare & Medicaid Services manages a website called “Medicare Hospital Compare” -- http://www.medicare.gov/hospitalcompare/ -- which provides data on costs, timely and effective care, readmissions, complications, deaths, and use of medical imaging and related services.
Consistent with Medicare reimbursement rates, public and state insurers obtain discounted rates and do not pay the ‘charge master’ amounts. Similarly, most individuals with insurance are not exposed to the hospital charge master amounts. And, hospitals provide community-based, charitable benefits and financial aid to low income populations. Even so, the burden to pay hospital charges tends to fall on those who can least afford to pay -- the uninsured, underinsured, or those individuals and families with high deductible health plans that are unaffordable or fail to provide comprehensive coverage.