CMS data: KC hospital prices keep rising

Jun 4, 2014, 3:05pm CDT

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Top 10 most common inpatient procedures: A breakdown of costs for major joint replacement or reattachment of lower extremity

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The Centers for Medicare & Medicaid Services has released its second round of hospital cost data, showing that the average amount Kansas City hospitals are charging patients has risen by more than six percent.

The data shows hospital charges, or the "list price" for services before insurance is applied, from 2012. Last year, CMS released the information for the first time and detailed 2011 numbers.

FLASHBACK: Study: KC hospitals' procedure fees 'don't seem to make sense'

According to an analysis of both years' data, the average charge for inpatient procedures in Kansas City rose by 6.62 percent. In 2011, the average charge for all inpatient procedures was $33,298.26. That rose to $35,504.26 in 2012.

Among the ten most common procedures performed in Kansas City, charges increased the most for esophagitis, gastrointestinal and miscellaneous digestive disorders. Those all fall under the same diagnosis code. The average charge for that diagnosis rose by 14 percent from $21,022.51 to $24,026.88.

When CMS first released its data last spring, consumers were struck by the wide variation in prices at hospitals, even within the same geographic region. That trend continued with the most recent release.

COVER STORY: Examining care costs: Pricing system hides savings opportunities

For the most common inpatient procedure performed in Kansas City — a major joint replacement or reattachment of a lower extremity — charges ranged from an average of $25,601.37 at Truman Medical Center Lakewood to $71,270.16 at Research Medical Center. That's a difference of more than $45,000.

Interestingly, it cost an additional $8,653.20 to have that same procedure done at Truman Medical Center's Hospital Hill campus rather than at its Lakewood location. There, the average charge for a joint replacement was $34,254.57.

However, experts and hospital administrators say the charge information is relatively useless for consumers, because very few people actually pay the charge price. Insurance companies negotiate that charge down, often by tens of thousands of dollars, for their customers. Hospitals also offer charity care and reduced prices for those who meet their requirements.

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The CMS data, although falling short of listing the actual price paid by consumers for medical services, did release what it calls "average total payments." That includes the total amount that hospitals were actually paid for services from insurance, individuals, Medicare and federal payments. It does not break out what individuals paid out of pocket.

The average total payments Kansas City hospitals received fell between 2011 and 2012 by 1.02 percent. However, the average amount Medicare paid to hospitals also fell by 1.59 percent, which likely accounted for at least some of that payment decline.




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