20 Oregon Hospitals That Charge The Most
Tuesday, March 24, 2015
By comparing Inpatient Discharge Data from the Oregon Health Authority from 2013, Act Now for a Healthy Oregon ranked hospitals on the average charge for primary diagnosis and length of stay.
See Slides Below: 20 Oregon Hospitals That Charge The Most
In one example of the difference, McKenzie-Willamette Medical Center in Springfield would charge $30,117 for an appendectomy and overnight stay in the hospital, while Wallowa Memorial Hospital in Enterprise would charge $9,055.
“The average Oregonian has very little choice of where to go to the hospital, and has no idea what the cost is going to be until the bill comes,” said Felisa Hagins,
political director for the SEIU Local 49, who assembled the report. “It’s a big deal when there’s there is no rhyme or reason why [the charges differ].”
The hospital with the average highest charges was Sky Lakes Medical Center in Klamath Falls followed by Asante Rogue Regional Medical Center in Medford and Legacy Emanuel Hospital and Health Center in Portland.
Not the Whole Picture
The report ranks the hospitals based on average charges for patients with commercial insurance only. Hospital professionals say this does not paint an accurate picture of how much consumers pay and hospitals profit, however.
“The SEIU report's use of internal hospital charges is intended to confuse the debate over hospital prices. In most cases, payments are predetermined by Medicaid and Medicare, which are much lower than what it costs to provide the service,” said Andy Van Pelt, Executive Vice President of Oregon Association of Hospitals and Health Services.
“Finally, a majority of hospitals in Oregon provide free care to individuals with incomes up to 200 percent of the federal poverty level, or about $48,500 annually for a family of four. So, what patients pay and what hospitals are reimbursed are both far less than their report alleges.”
Kathleen Nickel, communications director for Mercy Medical Center, said private insurance, Medicare or Medicaid may provide discounts. When patients do pay through Medicaid or Medicare, hospitals only receive a set government rate, often the same no matter what the individual hospital charges.
The hospital also reduces the medical bill to zero for patients with income two times above the federal poverty level, shifting some costs to commercially insured patients.
Differences in Charges
The reported pointed out differences in hospital charges did not seem to correlate with either an urban or rural settings of a hospital. Although the most expensive hospitals tended to be in more populated areas, a number of urban hospitals had some of the lowest charges, such as Kaiser-operated hospitals in Portland.
What hospitals charge does not always indicate the quality of care provided either, the report revealed. Of the 10 highest-charging Oregon hospitals, eight received one or more quality penalties from the federal Centers for Medicaid and Medicare Services in 2014.
A 2014 national study in Health Affairs found while more expensive hospitals tend to be larger and have specialized services, quality varies between the highest and lowest charging hospitals.
Regulating Hospital Charges
This legislative session, a number of bills seek to improve the variances in charges and create transparency for consumers.
On Wednesday, March 25, there will public hearings for Senate Bill 665, which would create a Hospital Rate Commission to oversee hospital charges and regulate price increases, and Senate Bill 891, which would require hospitals to disclose the actual prices charged for the 100 most common procedures. Both bills are backed by the SEIU Local 49.
The OAHHS is supporting Senate Bill 900 this session, which would create a website to compare prices paid for common procedures.
“Hospitals share the goal of providing better price information to patients so they can make informed decisions,” Van Pelt said.
Other states have taken similar steps and seen positive results, according to Hagins, such as Maryland and West Virginia who have set hospital prices. Hagins hopes Oregon will take steps towards a more transparent system.
“The industry will talk of the complexity of cost and pricing, but that doesn’t prevent them from being transparent or up front,” Hagins said. “We are interested in quality, affordable care and we hoping to see transparency.”
Related Slideshow: 20 Oregon Hospitals That Charge The Most
Which Oregon hospitals charge the most? Act Now for a Healthy Oregon analyzed 2013 data from Oregon Health Authority’s Inpatient Discharge Data for each of the 100 most frequent MSDRG primary diagnoses. An average charge was calculated per diagnosis (MSDRG) per hospital for patients with commercial insurance.
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