Tuesday, January 23, 2018
Health

Tampa Bay hospital charges vary widely, Medicare data show

Shopping around for hip replacement surgery? Morton Plant Hospital in Clearwater charges $49,370 on average, while Oak Hill Hospital in Brooksville charges more than twice as much at $118,735.

In downtown St. Petersburg, Bayfront Medical Center charges $75,739, but you could pay about 30 percent less at St. Anthony's Hospital less than two miles away. Or $93,130 at nearby Edward White Hospital.

Wondering what's going on? So are federal officials who released the information on Wednesday to shed light on hospital pricing practices that appear wildly out of control. And hospitals say they don't even expect to be paid anything close to what they are charging.

But these charges matter.

"If you are uninsured and you are going to the hospital for needed care, chances are these are going to be the prices that you are charged," said Jonathan Blum, deputy administrator of the Centers for Medicare & Medicaid Services on Wednesday.

In publicizing what hospitals charged in 2011 for the 100 most common in-hospital procedures covered by Medicare, the Obama administration also shared what Medicare paid — a fraction of the hospitals' charges. The release is part of ongoing efforts to help consumers make more informed decisions on health care, and raise questions about industry practices.

Hospitals know what Medicare will pay, so why do they charge more?

Experts point to the complex contracts that hospitals sign with the commercial insurers, who historically paid a portion of the full charges. Some still do.

This has created incentives for hospitals to raise their charges endlessly, even though most insurers have moved to reimbursements closer to Medicare's payment system.

"Over history, these charges have become absurd," said Steve Short, chief financial officer at Tampa General Hospital. "Charges over the years have become less and less meaningful, but there still is some small portion of how we get paid that is sensitive to the charges."

Tampa General, he explained, may charge more than other hospitals because it teaches medical students and provides costly services like heart transplantation. It also has a high share of uninsured patients. So it receives a little more from Medicare — although nowhere near its full charges.

In the Tampa Bay region, the hospitals affiliated with the not-for-profit BayCare Health System reported some of the lowest charges. These included St. Joseph's in Tampa, and St. Anthony's and Morton Plant in Pinellas County ­­— though their charges still exceed Medicare rates.

Chief financial officer Tommy Inzina said its relatively low charges are by design, recognizing that some consumers pay a percentage of charges under their insurance plan deductibles.

"While the charging system for hospitals is very complex, we believe as a community-based not-for-profit, we should be on the lower end of the market," he said.

By comparison, several hospitals affiliated with the for-profit HCA hospital chain, including Oak Hill, Edward White and Regional Medical Center Bayonet Point, had the highest charges in the region for common procedures like joint replacement surgery and pneumonia treatment.

In a statement, HCA said that it offers discounts to the uninsured. Most hospitals say they have such policies, though even discounted bills are well out of range for most uninsured people.

Health Management Associates — the for-profit company that now owns Bayfront Medical Center in St. Petersburg — offers a 64 percent discount on its charges, said Alan Levine, the senior vice president overseeing its 23 hospitals in Florida.

He cautions that the hospital charge data "can be misleading, if you are not careful."

Yet he welcomes the scrutiny. As secretary of the Florida Agency for Health Care Administration, Levine oversaw in 2005 the release of similar hospital pricing figures.

"My advice to patients would always be to look at all the data," he said, "and have an educated conversation with your doctor and your insurance company. More information is better than less."

Letitia Stein can be reached at [email protected] or (727) 893-8330.

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