Many people know health care costs seem to be going through the roof, and there is a lot of blame that is passed around for the trend. Some say it is doctors, some pharmaceutical manufacturers and some say it is the hospitals themselves.
And finally many blame insurance companies and the government along with them.
The equality of costs between areas and services have also been questioned nationally and locally. But when the Federal Database of National Healthcare costs was released last Wednesday concerning the charges that hospitals put on customers for many standard procedures, there were some good surprises and some bad ones.
Nationally and along the Wasatch Front between charging health care institutions there were some real discrepancies. In some cases one procedure at one hospital might cost thousands of dollars more than it does at a medical facility only a few miles away.
But locally, when Castleview Hospital is compared to hospitals along the Wasatch Front, their prices were not much out of line, in fact in some cases their charges were lower.
"We are committed to doing all we can to serve the healthcare needs of our community by providing high quality care in the most cost-effective manner," stated Mark Holyoak the CEO of Castleview Hospital. "At Castleview Hospital we support transparency efforts to make information, including pricing information, available to consumers."
The general report covered 100 procedures that are performed in metropolitan hospitals. Consequently Castleview did not figure into all 100, but did match up with 12 of the procedures that it had in common to the Wasatch Front hospitals.
Nationally it appears to some that often patients who don't have health insurance may end up paying much more than they have to when there are more inexpensive options in a local area. The released information could give insurance companies and others the leverage they need to broker deals with hospitals that are nearby to each other yet charge very different prices for services. Medicare and Medicaid also figure into the picture as well.
"It is important to point out that the information regarding charges does not reflect what our hospital is paid by Medicare or other payers. Medicare and Medicaid pay less than the cost of caring for patients," stated Holyoak.
The report revealed two figures. One figure is the figure that hospitals say they would charge for a procedure, and the other the actual average settlements they get for those services.
The case of charity care and non-paid care is a large issue in the health care industry, especially when it comes to hospital stays. Holyoak stated that charity care is a big piece of what the hospital adds to the community, with over $2 million a year in services written off to charity and uncompensated care.
"The hospital bears the burden of these costs," stated the CEO. "This is part of our mission. In addition to charity care, our hospital offers flexibility for patients who do not have health insurance and who are unable to pay the full cost of care."
The Sun Advocate took the information from the report and compared the procedures that are done at Castleview that were reviewed in the report and placed them along side charges for the same procedures at Mountain View Hospital in Payson, the Utah Valley Hospital in Provo, the Intermountain Medical Center (IHC) in Murray and a sister hospital to Castleview in the Uintah Basin, the Ashley Valley Medical Center.
In most cases Castleview is comparable to the Wasatch Front Hospitals. Some final figures are a little higher, while others are a little lower. There were also a number of procedures that Castleview performs that were not reflected in the other hospitals operations, particularly in comparison with the Ashley Valley Medical Center.
For instance in the case of septicemia or severe sepsis without mechanical ventilation (MV) for 96 hours with major complication/cormorbidity (which reflects the highest level of severity) Castleview's claimed charges were $20,561 while when all was said and done they accepted an average payment of $8,272. At the Utah Valley Hospital the claimed charges were $34,603 while accepting $12,880. Mountain View Hospital claimed charges of $33, 418, accepting $11,149. With Intermountain Medical Center the charges were $32,082 with them accepting $13,181. In the case of this procedure/hospitalization, Castleview's charges were below every other hospital it was compared to.
That is not the case with every procedure, but overall it appears the local Carbon County hospital is not out of line with what hospitals that local residents might go to, charge for their procedures.
"The CMS data does not show a complete picture of our hospital's costs or the factors that drive costs, such as severity of cases, lengths of stay and the amount of charity care and uncompensated care we provide," stated Holyoak.
In one case the local hospital seems to be higher than the others; that of major joint replacement. Holyoak felt that was due to the extreme care that doctors at Castleview take when caring for patients with these kinds of procedures.
"Charges for surgical procedures are all based on minutes in surgery," he stated. "Our orthopedic surgeons are very quality driven and meticulous with their surgical skills. Because of this, the surgeries often may take longer than they would elsewhere. Although this could increase the charges, I know that the outcome for the patient will be a quality outcome because of the attention to detail by these surgeons."
The chart on this page provides all the comparisons that were possible for Castleview from the CMS report. For more information about the Medicare program, and data about its payments and charges the Utah Hospital Association has more information.