New Federal Report Shows Price Differences For Health Procedures

A federal report shows medical procedures differ in cost, depending on which community and which hospital you visit.

The newly released report says the cost of surgery can vary by thousands of dollars or more in the same state and even in the same city.

The database was compiled by the Centers for Medicare and Medicaid Services.

Patients can search any hospital in any state in the country, and see what they charge for the top 100 in-patient procedures.

For example, the average cost for major joint replacement in Oklahoma varies widely in cost.

In Durant, the average is $93,000. In Tulsa, you could pay anywhere from $29,000 to $80,000 for the same surgery. In Oklahoma City, the average is $28,000 to $75,000. Tahlequah was on the low end with an average cost of $26,000.

Average cost of major cardiovascular surgery, according to CMS, shows Oklahoma City is on the high end, depending on which hospital you visit. The report says costs are between $51,000 and $150,000. In Midwest City, the average was $114,000 for the same surgery. In Tulsa, the range was between $57,000 and $75,000 according to CMS.

News On 6 reached out to Tulsa's two biggest hospitals and the state hospital association for their response to the report.

Hillcrest Health Systems response:

"It's important to know that not a single patient pays these charges, and it's unlikely that any health insurance company would have to pay them either. The amounts that are important are the payments: (1) payments that are set by the State of Oklahoma for Medicaid, (2) payments that are set by the federal government for Medicare, and (3) payments that are determined by negotiations with health insurance companies for nearly everything else. Medicare and Medicaid pay less than the cost of caring for patients. Additionally, as America's health care safety net, hospitals see, treat and heal uninsured and underinsured patients every day. In our community, the uninsured and underinsured receive tremendous discounts from Hillcrest HealthCare System or at times we cover the costs completely."

St. John Health Systems response:

"The information released today by Medicare shows that charges by hospitals rarely reflect what is paid by the government or private insurers. On average, U.S. hospitals collected only 91 cents of every dollar spent in caring for Medicare patients in 2011. As a non-profit community-based healthcare system, St. John provides more than $60 million in unpaid care for the poor, financial support for community clinics, free or low-cost educational seminars for the public, and physician, nurse and other medical professional training programs.

St. John Health System remains committed to delivering healthcare to all, regardless of ability to pay. We maintain competitive pricing, and are one of the lowest cost tertiary care providers in Oklahoma. St. John carefully weighs estimated costs of treatments and procedures, and offer financial assistance to patients without access to health insurance."

The Oklahoma Hospital Association says Oklahoma law limits how much hospitals can collect from lower income patients.

"Hospital charges are complex, and hospitals' methods for setting and adjusting prices vary widely. Many hospitals' higher prices reflect the costs of caring for the uninsured, and of providing unprofitable services such as burn units, trauma care, and medical education. Although prices can be a factor in hospitals' contract negotiations with health insurers, these contracts often set payment amounts that are not directly related to the "list" prices. Consumers' out-of-pocket costs for hospital services are not usually related to the hospital's prices, but are based on the consumer's health plan design.

Oklahoma has a law limiting the amount hospitals can collect from uninsured patients with incomes less than 300% of the federal poverty level."

The OHA adds it supports "price transparency." The association says it started a comparative hospital pricing web site in 2007. Similar information is now available online from the Oklahoma State Department of Health.