Two major healthcare chains say a report that found their hospitals have the nation's steepest cost-to-charge markups mischaracterizes how much patients actually pay for their services, the Tampa Tribune reports.
The charge-to-cost ratios do not accurately reflect the amounts insurers, government agencies or consumers must pay, Tomi Gamlin, spokeswoman for Community Health Systems (CHS), told the Tribune. "All hospitals are required to maintain a chargemaster, or a list of prices, for the numerous services they provide," Gamlin said. "However, these charges rarely reflect what consumers actually pay for their healthcare."
The Centers for Medicare & Medicaid Services requires hospitals to compile such a price list, which the government and health payers use to negotiate service rates with providers. While in theory this list only applies to uninsured or out-of-network patients, Gamlin said all CHS hospitals offer discounts to uninsured and charity-care patients, meaning not all of those patients actually pay the listed prices.
The other chain, Hospital Corporation of America (HCA), argued that type of coverage, rather than list prices, primarily determines the final amounts patients owe. Like CHS, HCA also offers free and discounted care for uninsured patients, the chain said. HCA West Florida spokeswoman J.C. Sadler also noted that the chain was one of the first providers to publish detailed pricing data.
Moreover, the report is missing some vital context for the data, such as the hospitals' collection prices and how the charges affected patients and families, according to Jay Wolfson, a professor of public health and medicine at the University of South Florida. "I think it's an important statement, but I think you have to dig a little deeper into the data, and avoid using words like 'gouging,'" he told the Tribune.
A report last year from National Nurses United reached similar conclusions about CHS, finding that of the nine most expensive hospitals, six were members of either CHS or Health Management Associates, which CHS arranged to purchase in 2013, FierceHealthFinance previously reported.
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