Hospital Charges Show Wide Variation; New Medicare Data Released

HHS last week announced a three-part initiative that for the first time gives consumers information on what hospitals charge. New data released shows significant variation across the country and within communities in what hospitals charge for common inpatient services. For example, average inpatient charges for services a hospital may provide in connection with a joint replacement range from a low of $5,300 at a hospital in Ada, Oklahoma, to a high of $223,000 at a hospital in Monterey Park, California. Click here for the NY Times story.

One important point: these are hospital charges; they don’t show what hospitals actually get paid. Medicare only reimburses, on average, one-third of what hospitals bill. Private health insurance plans set their own rates with these providers.

Even within the same geographic area, hospital charges for similar services can vary significantly. For example, average inpatient hospital charges for services that may be provided to treat heart failure range from a low of $21,000 to a high of $46,000 in Denver, Colorado, and from a low of $9,000 to a high of $51,000 in Jackson, Mississippi. Click here for very good HHS summary. Click here for the American Hospital Association response.

The Washington Post has put together an easy way to find the charges for every hospital.  Click here.

The data provided includes hospital-specific charges for the more than 3,000 U.S. hospitals that receive Medicare Inpatient Prospective Payment System payments for the top 100 most frequently billed discharges, paid under Medicare based on a rate per discharge using the DRG for FY11. These DRGs represent almost 7 million discharges or 60% of total Medicare IPPS discharges. Click here to access the original data set, 163,000 lines of data.


Leapfrog Issues Hospital Safety Grades for Spring

Leapfrog last week issued its spring update to the Hospital Safety Score that assigns “A”, “B”, “C”, “D” or “F” grades to more than 2,500 general hospitals in the United States. It showed hospitals have made only incremental progress in addressing errors, accidents, injuries and infections that kill or hurt their patients. With 80% of its hospitals receiving an “A”, Maine edged out Massachusetts as the number one state for safety. Joining Maine and Massachusetts in the “top five” ranking for number of “A” Scores are Minnesota, Virginia and Illinois. Click here to see hospitals’ safety scores.


Study Says Magazine’s Hospital Rankings Might Mislead Readers

A new study out last week, from a company specializing in comparing the cost and quality of medical care, suggests patients and purchasers may be misled by hospital rankings released in U.S. News & World Report’s 2012-2013 national honor roll of best academic medical centers. The study has a number of potential shortcomings which may limit the usefulness of the rankings, according to the new research. Click here for details.


Senators Want Input to Improve Physician Payment System

U.S. Senate Finance Committee Chairman Max Baucus (D-MT) and Ranking Member Orrin Hatch (R-UT) last week called on physicians and other providers from across the country to bring ideas to the table on how to improve Medicare’s physician payment system. In a letter to health care providers, the senators called the current Medicare payment system “broken” and said it was time to repeal the flawed formula and end the annual “doc fix” ritual. May 31 is the deadline to submit comments. Click here to read their letter.


Study Says Hospitals Don’t Cost-Shift from Medicare to Private Payors

Contrary to the belief that hospitals charge private payers higher payment rates to offset lower Medicare rates, it turns out the opposite is true, lower Medicare payment rates lead to lower private rates for inpatient care, according to a study by the Center for Studying Health System Change published in the May Health Affairs. Click here for a summary.


Cancer Center Business Model Changing, Hurting Because of Budget Cuts

Combined with the federal budget sequester and previous payment formula changes, the cancer center business is changing. One of the consequences is less access. According to one survey, over half of oncology practices had been consolidated to closed in the past four years. Click here for the 15-page survey. Click here for the story.


Small Businesses Say Obamacare Bad for Business: Survey

48% of U.S. small business owners say the 2010 Affordable Care Act is going to be bad for their business, compared with 9% who say it is going to be good, and 39% who expect no impact. Click here for more of the Gallup survey.


Obama Publicly Fighting for Obamacare

President Obama has decided to fight a growing public perception that Obamacare isn’t what it’s cracked up to be. He came out fighting in defense of his health care law late last week, saying that he was “110% committed” to delivering its benefits on schedule, and that consumers should not be bamboozled by critics spreading misinformation about the law. Click here for the story.


HHS Secretary Soliciting Private Obamacare Promotion Funds

According to a report last week in the Washington Post, HHS Secretary Kathleen Sebelius has started asking health industry officials to make large financial donations to help with the effort to implement President Obama’s landmark health care law. Click here to read the report.


$150 Million Awarded to Health Centers to Promote Enrollment

HHS announced last week it will provide about $150 million to help community health centers provide in-person health insurance enrollment assistance to uninsured individuals across the nation. About 1,200 health centers operate nearly 9,000 service delivery sites nationwide and serve approximately 21 million patients each year. Click here for details.


Business Coalition Urges Congress to Stop Automatic Signup

A coalition of major retailers, restaurant chains, trade groups and others sent a letter to Congress last week backing repeal of an Affordable Care Act provision requiring companies with 200 or more employees to automatically sign up their workers for health coverage if they don’t pick their own. Click here to read the letter.


Obamacare Provision Would Penalize Generous Health Benefits to Execs

Many executives enjoy free health care and better health benefits for themselves and their families. But under a little noticed anti-discrimination provision in the Affordable Care Act, such advantages could soon trigger fines of up to $500,000. The provision says that employers who offer more generous benefits to highly paid workers could face fines of $100 a day for every worker who doesn’t get the perks, up to $500,000. Click here for the Kaiser Health News story.


Study Says Capping Top Health Benefits Would Raise Hundreds of Billions

An Urban Institute analysis released last week says capping the tax exemption for employer-sponsored health coverage to allow the top 25% of the most expensive health benefits to be taxed would raise $264 billion by 2023. The exemption reduced the tax revenues that the government collected by a total of $268 billion in 2011. Click here for the report.


House to Vote to Repeal Obamacare This Week

For at least the 33rd time, the House of Representatives will vote to repeal the Affordable Care Act. The Senate is not likely to vote on this issue. Click here for the story.


House Bill Would Reform Medicaid

U.S. Rep. Bill Cassidy (R-LA), a physician, has introduced legislation to reform Medicaid.  There are seven major provisions. Click here for the one-page summary. Click here for a 20-page summary of a GOP analysis of Medicaid.


U.S. Docs Increasing Use of EMRs

Electronic prescribing and EMR use among U.S. physicians increased by 34% annually, while routine HIT use by physicians in seven other countries including Canada and France saw a 15% annual increase, according to a study from Accenture. The study found that 93% of responding U.S. doctors actively use EMRs and 45% access clinical information from external sources. Click here for the report.


Report Says Primary Care Docs Generate More Hospital Revenue than Specialists

Primary care physicians generate more revenue for their hospitals than specialists: $1.57 million versus $1.42 million, respectively, according to a May report from recruiting firm Merritt Hawkins. Click here for the report. In another report, revenue generated by primary care physicians jumped 23% while specialists’ generated revenues declined 10% over the past decade, according to Medical Economics. Click here.


Misdiagnoses More Common than Drug, Surgery Errors

Medical diagnoses that are missed, incorrect or delayed are believed to affect 10 to 20% of cases, far exceeding drug errors and surgery on the wrong patient or body part, both of which have received considerably more attention, according to a variety of studies. Click here for an interesting Washington Post story on the issue.


Drug Spending Falls For First Time in 50 Years

For the first time in more than 50 years, per-person prescription drug spending fell in 2012, a new IMS Institute for Healthcare Informatics study finds. Total spending per capita decreased by 3.5% or $33, to $898. Click here for the study.


WalMart Health Care Behemoth?

WalMart may become a healthcare provider giant, according to a growing number of published reports. Why? U.S. spending on health care is poised to surpass spending on retail, the only developed economy where that’s the case, and Wal-Mart has natural advantages like foot traffic and scale. About 150 million Americans visit a Wal-Mart every week, spending about 50 minutes on average. Click here for the story.