The American Hospital Assn. supports transparency in hospital billing, according to a statement the group issued after the Centers for Medicare & Medicaid Services exposed large swaths of billing and reimbursement data for member hospitals.
The CMS data caused something of a stir by exposing definitively how different hospitals, even those within the same state or city, charge vastly different amounts for identical procedures.
"For years, the AHA has supported federal price transparency legislation," the AHA said in a press release. "The AHA and its members stand ready to work with policymakers on innovative ways to build on efforts already occurring at the state level, and share information that helps consumers make better choices about their health care."
The AHA defended certain aspects of healthcare pricing while calling for more transparency in billing. Charge variations, the group said, is a "byproduct of the marketplace." Insurance groups negotiate rates with individual hospitals based on a number of factors, including hospital reputation and scope of services, and "it would create serious antitrust risks for hospitals to share the proposed or negotiated rates with each other," the AHA warned.
The data, and reactions to it, came amid growing concerns about the obscurity of the cost of care in the U.S. Various studies have exposed how difficult it can be for patients attempting to gauge their medical expenses, especially for complicated procedures. Even hospitals themselves have had trouble figuring out how much a procedure may cost ahead of time.
Earlier this year a Washington University project intended to uncover the cost of hip replacement procedures made the unindented discovery that around half of the hospitals could provide no estimates. Among the more than 100 hospitals contacted by the researcher, those that could provide figures ranged from around $11,000 to more than $125,000.
U.S. healthcare regulators this month made the unprecedented move of publishing charges submitted by more than 3,000 hospital, related to the 100 most frequently billed charges for fiscal year 2011. The full data includes some 7 million charges, representing about 60% of Medicare’s Inpatient Prospective Payment System, according to the report.
"As part of the Obama administration’s work to make our health care system more affordable and accountable, data are being released that show significant variation across the country and within communities in what hospitals charge for common inpatient services," according to the report.
The data cast light on the vast disparities between what hospitals charge for identical procedures, even hospitals that are just blocks apart in the same city. In Miami, Fla., the University of Miami Hospital charged an average of $127,038 for a pacemaker implant while the Jackson Memorial Hospitals just a stone’s throw away charged $66,030 for the same procedure, the Washington Post reported.
