The data set was released on Wednesday by the Centers for Medicaid and Medicare Services. This is the first time the data is being made accessible to the public.
Includes hospital-specific charges for the more than 3,000 U.S. hospitals that receive Medicare Inpatient Prospective Payment System (IPPS) payments for the top 100 most frequently billed discharges, paid under Medicare based on a rate per discharge using the Medicare Severity Diagnosis Related Group (MS-DRG) for Fiscal Year (FY) 2011. These DRGs represent almost 7 million discharges or 60 percent of total Medicare IPPS discharges.
Acting on the suggestion of her top data crunchers at the department’s Centers for Medicare and Medicaid Services (CMS), Health and Human Services Secretary Kathleen Sebelius released an enormous data file on May 8 that reveals the list—or “chargemaster”—prices of all hospitals across the country for the 100 most common inpatient treatment services in 2011. It then compares those prices with what Medicare actually paid hospitals for the same treatments—which was typically a fraction of the chargemaster prices.
One hospital charges $8,000 — another, $38,000 (via Washington Post)
Note: Includes interactive infographic, “How much do providers charge in your state?”
Until now, these charges have been closely held by facilities that see a competitive advantage in shielding their fees from competitors. What the numbers reveal is a health-care system with tremendous, seemingly random variation in the costs of services.
There is some debate about how much patients, insurance providers and the government actually end up paying. “It’s true that Medicare and a lot of private insurers never pay the full charge,” said assistant professor at the University of California at San Francisco Medical School, Renee Hsia, “But you have a lot of private insurance companies where the consumer pays a portion of the charge. For uninsured patients, they face the full bill. In that sense, the price matters.”