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Friday, May 17, 2013

Browse the Medicare Hospital Charges and Payment Data

Posted by on Fri, May 17, 2013 at 1:31 PM

As I wrote about last week, Medicare (for the first time ever) released what hospitals in the United States charged, and what they were paid, for the top 100 diagnoses in 2011.

If you're curious, I've written a simple (and ad-free) web app you can use to browse the data. (I suggest comparing the Las Vegas, NV region to Baltimore, MD.)

Be gentle, but have at it.

 

Comments (10) RSS

Oldest First Unregistered On Registered On Add a comment
1
Thanks! This kind of tool, with a lot more data, is what consumers really need.
Posted by wxPDX on May 17, 2013 at 1:37 PM · Report this
2
Nice work.
Posted by Mr John on May 17, 2013 at 1:59 PM · Report this
skidmark 3
Too bad an uninsured non-Medicare eligible individual can't just can't buy the service trough medicare and get those rates that way.
Posted by skidmark on May 17, 2013 at 3:04 PM · Report this
Fnarf 4
This is a fantastic tool, Jonathan. Transparency isn't the only thing missing from the American health care system, but it's a big one.
Posted by Fnarf http://www.facebook.com/fnarf on May 17, 2013 at 5:53 PM · Report this
Grant Brissey, Emeritus 5
This is great, Jonathan. You are excellent.
Posted by Grant Brissey, Emeritus http://www.grantropolis.com/ on May 17, 2013 at 6:49 PM · Report this
rob! 6
Thanks, Dr. Golob. I downloaded the spreadsheet the day it was released, and found that it completely bogged down my zippy little laptop. Your site is actually usable. (Now why couldn't CMS have done that? It's almost as thought the administration doesn't give a rip whether Obamacare lives or dies.)

I hope you have time to comment on some of the issues this brings up, Jonathan.
Posted by rob! http://www.youtube.com/watch?v=QZBdUceCL5U on May 17, 2013 at 8:58 PM · Report this
rob! 7
If anyone's wondering, the alphabet soup at the end of most of the diagnoses in Jonathan's app is the "severity-adjusted diagnosis-related group [DRG]" coding that Medicare uses to reimburse hospitals for patient care.

First adopted in 1982, DRGs were a major step away from pure cost-based reimbursement and thus an important part of containing health-care cost increases (though prices have obviously continued to escalate rapidly over the last 30 years).

The "severity-adjusted" refinement is a way of reducing the total number of codes required to be used when seeking reimbursement from Medicare. "Cc" means the base diagnosis PLUS common co-morbidities and complications, while "Mcc" means major co-morbidities and complications. "W" and "W/O" mean with or without, obviously.

Now if we could just get to where ALL physicians and hospitals are paid based on OUTCOMES, rather than diagnoses.

http://en.wikipedia.org/wiki/Diagnosis-r…

http://www.irpsys.com/articles%5Cszh_med…
Posted by rob! http://www.youtube.com/watch?v=QZBdUceCL5U on May 17, 2013 at 11:32 PM · Report this
Dr_Awesome 8
Very interesting. I had a recent stay at Hotel Swedish and they charged 2.5X the rate listed for my condition. My private insurer paid about 80% of that.

I never received an itemized bill, so all I know is the total cost for the whole shebang. ER + OR treatment + 4-day stay in ICU.

I am assuming the codes are for only the listed treatment, and any followup stay in the hospital is charged via a different and separate code. Or is it all bundled into the codes & costs listed? If the charge includes the required hospital stay, then Swedish charged my insurer two-and-a-half times the Medicare cost.
Posted by Dr_Awesome on May 18, 2013 at 7:27 AM · Report this
julie russell 9
@7...or, in mental health related illness, ICD-9s
Posted by julie russell http:// on May 18, 2013 at 2:28 PM · Report this
10
Just adding my thanks to Dr. Golob for the "fantastic tool," & to rob! for clarifying the "severity-adjusted" refinements Cc & Mcc.
Posted by blurch on May 26, 2013 at 11:29 AM · Report this

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