This report includes median hospital charge information for discharges falling within a given severity level for a diagnostic condition (MSDRG). The policy and setting of charges is determined by individual hospital. While charges are what the hospital reports on the billing form, they may not accurately represent the amount a hospital receives in payment for the services it delivers. However, hospital charges are used almost universally by those attempting to assess the costs of health care. Hospital charge data does not include separate physician charges.
The charges listed are averages for items and services
provided by hospitals, based on the number of patients and total charges for
that illness. Figures include charges for the hospital room, meals, 24
hour Nursing care, 24 hour Pharmacy, Oxygen and IV Therapy, Physical and
Respiratory therapy, Laboratory tests, state-of-the-art equipment (x-ray, MRI,
CT), pharmaceuticals and patient supplies such as gowns, walkers and
The median value was used in order to eliminate problems with extremely low or high charges. Without these extreme values, the average charges and the typical range of charges are more representative of the charges that most patients would experience. A hospitalís charges for the 10th percentile and 90th percentile reflect a statistical standard range. About 80% of the time, the hospitalís total listed charge will be between the 10th and 90th percentiles. This helps to tell you what is likely to happen within a given hospital. Because these figures are averages, they may be different from what you are billed. The numbers do not measure quality of care.
Why Charges May Vary
Charges vary because no two patients, conditions, reactions to medications or treatment, or time of recovery are identical.
Individual physician judgment based on patient needs influences treatment decisions. Some MSDRGs have little variation of charges within the minor severity level because physicians agree on standard treatment procedures. Other MSDRGs can have a significant range of charges because the MSDRG includes a wide variety of illnesses and treatment among these illnesses is not standardized. Charges may be higher at hospitals located in areas of the state where wage levels and cost of living is higher. Hospitals affiliated with medical schools and those which incur additional costs associated with training medical and allied health students may also have higher charges.
ALERT - May 16, 2012
A provision contained with Section 2718 of the Patient Protection and Affordable Care Act (ACA) contains a requirement for all U.S. hospitals to make charge information publicly available. This provision specifically states:
ďEach hospital operating within the United States shall for each year establish (and update) and make public (in accordance with guidelines developed by the Secretary) a list of the hospitalís standard charges for items and services provided by the hospital, including for diagnosis-related groups established under section 1886 (d)(4) of the Social Security Act.Ē
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