News Release
U.S. Department of Health & Human Services
News Division
202-690-6343
FOR IMMEDIATE RELEASE
Wednesday, May 8, 2013
Administration offers consumers an unprecedented look at hospital charges
Today,
as part of the Obama administration’s work to make our health care
system more affordable and accountable, Health and Human Services (HHS)
Secretary Kathleen Sebelius announced a three-part initiative that for
the first time gives consumers information on what hospitals charge.
New data released today show significant variation across the country
and within communities in what hospitals charge for common inpatient
services. Also today, HHS made approximately $87 million available to
states to enhance their rate review programs and further health care
pricing transparency. In an example of how these data might be used, the
Robert Wood Johnson Foundation (RWJF) is planning a data visualization
challenge which will further the dissemination of these data to larger
audiences.
“Currently,
consumers don’t know what a hospital is charging them or their
insurance company for a given procedure, like a knee replacement, or how
much of a price difference there is at different hospitals, even within
the same city,” Secretary Sebelius said. “This data and new data
centers will help fill that gap.”
The
data posted today on CMS’s website include information comparing the
charges for services that may be provided during the 100 most common
Medicare inpatient stays. Hospitals determine what they will charge for
items and services provided to patients and these “charges” are the
amount the hospital generally bills for an item or service.
"Transformation
of the health care delivery system cannot occur without greater price
transparency," said Risa Lavizzo-Mourey, M.D., RWJF president and CEO.
"While more work lies ahead, the release of these hospital price data
will allow us to shine a light on the often vast variations in hospital
charges."
These
amounts can vary widely. For example, average inpatient charges for
services a hospital may provide in connection with a joint replacement
range from a low of $5,300 at a hospital in Ada, Okla., to a high of
$223,000 at a hospital in Monterey Park, Calif.
Even
within the same geographic area, hospital charges for similar services
can vary significantly. For example, average inpatient hospital charges
for services that may be provided to treat heart failure range from a
low of $21,000 to a high of $46,000 in Denver, Colo., and from a low of
$9,000 to a high of $51,000 in Jackson, Miss.
To make these data useful to consumers, HHS is also providing funding to data centers to collect, analyze, and publish health pricing and medical claims reimbursement data. The data centers’ work helps consumers better understand the comparative price of procedures in a given region or for a specific health insurer or service setting. Businesses and consumers alike can use these data to drive decision-making and reward cost-effective provision of care.
To make these data useful to consumers, HHS is also providing funding to data centers to collect, analyze, and publish health pricing and medical claims reimbursement data. The data centers’ work helps consumers better understand the comparative price of procedures in a given region or for a specific health insurer or service setting. Businesses and consumers alike can use these data to drive decision-making and reward cost-effective provision of care.
The
Affordable Care Act also makes available many tools to help ensure
consumers, Medicare, and other payers get the best value for their
health care dollar. Medicare is beginning to pay providers based on the
quality they provide rather than just the quantity of services they
furnish by implementing new programs such as value-based purchasing and
readmissions reductions. HHS awarded $170 million to states to enhance
their rate review programs, and since the passage of the Affordable Care
Act, the proportion of insurance company requests for double-digit rate
increases fell from 75 percent in 2010 to 14 percent so far in 2013.
To view the new hospital dataset, please go to: http://www.cms.gov/Research-
To access the funding opportunity announcement, visit: http://www.grants.gov, and search for CFDA # 93.511.
For
more information on HHS efforts to build a health care system that will
ensure quality care, please see the fact sheet “Lower Costs, Better
Care: Reforming Our Health Care Delivery System,” at http://www.cms.gov/apps/media/
To read a fact sheet about the Medicare data showing variation in hospital charges, please see: http://www.cms.gov/apps/media/
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Follow HHS Secretary Kathleen Sebelius on Twitter @Sebelius
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