According to data from Payer Compass, which shows 2013-2015 data for overall ratios of charges to actual Medicare payment for all Medicare-certified hospitals, going to different hospitals close by in the region can result in very different bills.[i],[ii]
Because of Maryland’s partnership with the Centers for Medicare & Medicaid Services (CMS) between 2014-2016, “all-payer per capital total hospital revenue growth [was] limited to 3.58% per year.”[iii]
Compare the following hospitals. Holy Cross Hospital in Silver Spring charged 119% of Medicare payment overall in 2019. A mere 8.9 miles away, George Washington University Hospital charged 522% of Medicare in 2015. Another 8 miles southwest from GW, Virginia Hospital Center charged 318% of Medicare. Do you get 3-, 4-, or 5 times the care? Why are these hospitals’ percentages of Medicare payment charges so wildly different?
Are you an employer whose employees are spending your healthcare dollars? Do you want them to spend 4-5 times as much on care? There are ways to control these costs.
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[i] “Price Map Analytics,” PayerCompass, https://www.payercompass.com/price-map/
[ii] Harriet Blair Rowan, “Transparent Hospital Pricing Exposes Wild Fluctuation, Even Within Miles,” California Healthline, 24 January 2019, https://californiahealthline.org/news/transparent-hospital-pricing-exposes-wild-fluctuation-even-within-miles/
[iii] Les Masterson, “Maryland’s All-Payer Model Saved Medicare Millions in First 3 Years,” Healthcare Dive, 19 March 2018, https://www.healthcaredive.com/news/marylands-all-payer-model-saved-medicare-millions-in-first-3-years/519458/