ED Visits in CO Cost Hundreds to Thousands Depending on FacilityAugust 22, 2019
– In Colorado, the costs of an emergency department visit varied significantly by hospital and severity level, with median facility charges ranging from $190 to $4,700 in 2018, according a recent Center for Improving Value in Health Care report examining data from the all-payer claims database (ACPD).
The report also showed that payments for each individual severity level also varied statewide, which was typical of prices for other common healthcare services analyzed with data in the state’s APCD. For example, the most common range of payments for the highest severity code ranged from $1,990 to $4,700, while the highest facility payment for the same severity level in 2018 was almost $48,000, researchers reported.
Emergency department charges are high, but costs are likely much more, researchers warned in the report. The analysis only looked at what hospitals received from commercial insurers and patients for the evaluation and management (E/M) facility portion of the visit.
The analysis did not include amounts for other services which may be performed during the visit, such as lab tests, imaging services, surgical procedures, and other fees that are billed directly by the attending physician or providers.
This isn’t the first time reports have called out Colorado hospitals for high prices and price variation. An October 2018 report published in the Denver Post showed that hospital prices increased by 76 percent in the state over a seven-year period.
READ MORE: Inpatient Hospital Prices Rose 19%, Outpacing Physician Prices
A recent RAND Corporation analysis also found that relative hospital prices increased rapidly in Colorado from 2015 to 2017, with facilities in the state charging private payers between 250 and 300 percent of Medicare rates, well above the average mark-up observed across the nation.
But Colorado is not the exception to the rule. Hospital prices are rising across the nation, according to new research, and prices significantly vary within states, regional markets, and even facilities.
An issue brief released by the Health Care Cost Institute (HCCI) earlier this year uncovered up to a 25-fold variation in median prices for the same services across regions. For example, the analysis of commercial claims data showed that a C-section delivery in San Francisco-Oakland-Hayward, California ($20,721) is almost 4.5 times that in Knoxville, Tennessee ($4,556), and a common blood test in Beaumont, Texas ($443) is nearly 25 times more than the same test in Toledo, Ohio ($18).
Healthcare costs also varied within metropolitan areas, with HCCI researchers observing a 39-fold price difference for the same service within a given region.
Price variation spells trouble for employers and patients, as well as the industry at large, HCCI president and CEO Niall Brennan stated.
READ MORE: Driven By Prices, Private…