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Healthcare Key Findings, June 2013

Hospital Pricing Data Reveals Wide Discrepancies

hospital billing discrepanciesAccording to newly released data from the Health and Human Services Department’s Centers for Medicare and Medicaid Services (CMS), a vast disparity exists between what hospitals in the U.S. charge for pills, procedures and operations and the real costs of those services, as calculated  and paid by Medicare.  This is puzzling because, “Medicare uses actual expense data submitted by all hospitals to determine the actual costs of all treatments, including allocations of overhead such as rent or administrative salaries,” explains Steven Brill, author of TIME’s March 4, 2013, special report on health-care-pricing-practices, entitled, Bitter Pill.

The data file compares the average list prices of what hospitals in this country charge for the 100 most common inpatient procedures, which have been mostly kept private until now. A case of pneumonia, with no complications, cost $124,051 in Philadelphia and $5,093 in Water Valley, Miss., with an average charge of $24,549. In Washington, D.C., George Washington University Hospital’s average bill for a patient on a ventilator was $115,000, while Providence Hospital’s average charge for the same treatment was just under $53,000 despite being in the same city.

Hospitals contend pricing comes from a master list that can be confusing because it’s highly variable and generally not what a consumer would pay because discounts are negotiated with insurance companies. Yet, critics say these prices do matter because consumers often pay a portion or percentage of their bills, and uninsured patients face the full bill, even though some hospitals assist the uninsured in paying their bills. Medicare officials say they want to increase transparency in the health system and provide more clarity on charge data.


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  • Sleep deprivation can lead to weight gain. A Columbia University study reported that those who regularly slept just four hours were 73% more likely to become obese than those sleeping between seven and nine hours. Even people sleeping six hours were 23% more likely to become obese. (
  • More than eight in 10 “fitness enthusiasts” (those who work out three or more times per week) (82%) feel they aren’t practicing good nutrition habits after exercise. Most would like to improve the way they feel after working out, including 52% who would like to experience less muscle soreness and 42% who would like to have more energy. (EAS Sports Nutrition; 847-938-1505)
  • Almost one in five new food and drink products (19%) launched in the U.S. in 2012 were high-protein items. (Mintel; 312-932-0400)
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  • Of the 52% of U.S. adults who are currently “watching” their diets, 15% are doing so to monitor their sodium intake. (Mintel; 312-628-7936)

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