Advertisement

Editorial: Stop the gouging at hospital trauma centers

 
Eight months after the Tampa Bay Times first disclosed that many of Florida’s 25 trauma centers charge five-figure admission fees, reporters Alexandra Zayas and Kris Hundley have found the same disturbing trend nationwide.
Eight months after the Tampa Bay Times first disclosed that many of Florida’s 25 trauma centers charge five-figure admission fees, reporters Alexandra Zayas and Kris Hundley have found the same disturbing trend nationwide.
Published Nov. 26, 2014

In the aftermath of a natural disaster, merchants who jack up prices to make more profit can be charged with gouging. When hospitals nationwide set prices to take advantage of trauma victims who usually have no say in where they are taken or how they are treated, it's called a trauma center response fee. Twelve years after the fees first went into effect, the trauma center industry can't be trusted to police itself. The Florida Legislature and lawmakers in other states should move to tie these fees to the real cost of care.

Eight months after the Tampa Bay Times first disclosed that many of Florida's 25 trauma centers charge five-figure admission fees, reporters Alexandra Zayas and Kris Hundley have found the same disturbing trend nationwide. In the past six years, trauma center response fees have risen 87 percent, according to a confidential 2014 report for the Trauma Center Association of America obtained by the Times. The highest fee in 2007 was $24,964; in 2013, it skyrocketed to $47,546.

Just what is that cost based on? No one can say. Apparently it doesn't matter if a trauma center is Level I — which treats the worst cases — or Level III, which usually stabilizes patients until they can be transferred to a Level I center. Just as in Florida, the Times found nationally it is often the least-equipped trauma centers that charge the highest trauma center response fees.

The fees were created 12 years ago to ensure that the expensive trauma centers kept their doors open. But now it's clear that hospitals, particularly for-profit enterprises such as the Hospital Corporation of America chain, are viewing the fee more as a profit generator than a way to cover actual costs. What hospitals charge is not necessarily what they are eventually paid, due to negotiated rates with insurers or discounts given to cash-paying customers. But trauma centers can be paid based on a percentage of a patient's total charge, no matter the line item. And the impact of those higher costs to insurance companies ripples through the entire health care economy, raising private health insurance premiums for everyone.

Florida lawmakers made an effort earlier this year, following the Times original report, to put some limits on trauma fees, proposing a $15,000 cap for a year until the issue could be studied further. But even that tempered effort was too ambitious in the business-friendly Legislature. HCA managed to tie the proposed reform to its own effort to win legislative protection for its three newest trauma centers that have been challenged by older, more established competitors, which ultimately stalled the bill.

In the 2015 session that starts in March, Tallahassee should have no excuse for turning a blind eye to the gouging of trauma patients. After reviewing 260 hospitals in 30 states, the Times found five of the 15 hospitals with the highest trauma center response fees were in Florida. All are HCA facilities and include the $29,000 fee at Regional Medical Center Bayonet Point in Pasco County, the ninth highest in the country. It's time for the Legislature to stand with trauma center patients, not hospital chains seeking to cash in on their pain.