Monday, June 22, 2015

The 50 Most Expensive Hospitals

In May, I thought about data and information in Perfect Access to Perfect Information. Having data is comforting to many, and in pursuit of that data, researchers look at some amazing information. Of course, how that data is defined, refined, confined, and interpreted may have a great many variables. 

In June, WorkCompCentral reported that Johns Hopkins has published a study regarding hospital billing patterns. They say that "most hospitals charge 1.5 to four times the Medicare rate" for services. However, there are some hospitals "that charge 9.6 to 12.6 times the Medicare rates." They identified the "50 most expensive hospitals in the country" and say that these 50 charge up to "10 times the amount that Medicare pays."

According to a map published with the story, the list of 50 is in 13 states, as follows: 

Alabama 5
Arizona 1
Arkansas 1
California 3
Florida 20
Kentucky 1
New York 1
Oklahoma 1
Pennsylvania 7
South Carolina 1
Tennessee 3
Texas 5
Virginia 1 

According to the Census Bureau Florida has 19,893,297 of the 318,857,056 people in the United States, or roughly 6%.

According to Wikipedia (a trusted and cited authoritative source, see Trejo Perez v. Arry's Roofing, 141 So.3d 220 (Fla. 1st DCA 2014)), the United States includes 3,805,943.26 square miles. Florida is 65,757.70 square miles, or roughly 2% of that area. 

According to the Johns Hopkins study, twenty of the "50 most expensive hospitals in the country" are in Florida. That is, roughly 40% of the "most expensive" are in Florida. Pennsylvania is next with 14%, followed by Alabama and Texas tied at 10% each. These second and tied-for-third states total only 34%. Florida alone beat the next four runners-up in the count combined by a solid 6% margin.

According to Statista, there are 5,686 hospitals in the Unites States. According to the Florida Hospital Association, there are 303 hospitals in Florida. Florida has roughly 5.3% of the nation's hospitals. 

According to Statista, there are 914,513 hospital beds in the United States. According to the Florida Hospital Association, there are 67,081 hospital beds in Florida. Florida has roughly 7.3% of the nation's hospital beds.

Six percent of the U.S. population, two percent of of the U.S. land area, five percent of the hospitals, seven percent of the hospital beds, and forty percent of the "most expensive hospitals in the country."

According to a map published with the story, the following Florida Hospitals are in that group

Bayfront Health Brooksville (Brooksville)
Bayfront Health Dade City (Dade City)
Brandon Regional Hospital (Brandon)
Fawcett Memorial Hospital (Port Charlotte)
Ft. Walton Beach Medical Center (Fort Walton)
Gulf Coast Regional Medical Center (Panama City)
Heart of Florida Regional Medical Center (Davenport)
Kendall Regional Medical Center (Miami)
Lawnwood Regional Medical Center (Port St. Lucie)
Lehigh Regional Medical Center (Fort Myers)
North Florida Regional Medical Center (Gainesville)
North Okaloosa Medical Center (Crestview)
Oak Hill Hospital (Brooksville)
Orange Park Medical Center (Orange Park)
Osceola Regional Medical Center (Kissimee)
Regional Medical Center Bayonet Point (Hudson)
Sebastian River Medical Center (Sebastian)
South Bay Hospital (Tampa)
St. Petersburg General Hospital (St. Petersburg)
Twin Cities Hospital (Ft. Walton)

The WorkCompCentral story makes clear that these are included based upon what each is billing. That does not necessarily mean that this is what each is being paid. The story points out that there are fee schedules in workers' compensation, which may impact the amount that is actually paid. According to one source though, "Florida's fee schedule doesn't offer much protection to payers." 

The hospital study author, Ge Bai, is quoted explaining the "business model" that is being followed. She says there is a "market failure" caused by "the difficulty of finding and comparing the actual prices a patient can expect to pay for services." She says that "[b]ecause the information is hard to gather," "hospitals rarely have to compete with each other on pricing." Perhaps another argument in favor of Perfect Access to Perfect Information?

If consumers knew of the differences in expected cost, would they travel across town for services? Would Medical Tourism cause them to drive across their region, to another state, or to a nice beach town somewhere for services?

An interesting study. 

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