The premier resource for hospital professionals from Relias Media, the trusted source for healthcare information and continuing education.
ED visits: Should patients comparison shop?
March 18th, 2015
With health care costs increasing, and the majority of the costs distributed to the individual/patient, researchers decided to study variation in charges among hospitals, in particular the emergency departments (EDs) of these hospitals.
The study, published online, was a cross-sectional look at the variation in charges for ED visits in California hospitals. It focused only on those charges reported to California Ofﬁce of Statewide Health Planning and Development by nonfederal, acute care hospitals.
To understand the billing process, all charges are categorized into 5 levels:
- level 1 visits are minimal risk (i.e., suture removal);
- level 2 visits are low risk (i.e., ankle sprain);
- levels 3 and 4 are moderate risk (i.e., exacerbation of chronic or acute illness); and
- level 5 visit is high risk (i.e., chest pain or shortness of breath).
- charges for level 2 visits ranged from $156 to $1,422;
- charges for level 3 visits ranged from $266 to $3,130; and
- charges for level 4 visits ranged from $275 to $6,662.
- government hospitals charged significantly less than nonprofit hospitals;
- hospitals with higher proportions of Medicaid patients charged more; and
- hospitals that paid higher wages charged more.
“The largely arbitrary charge-master system in hospitals has a major bearing on the cost of medical care,” said Dr. Hsia. “The lack of systematic charge setting can have especially devastating effects on uninsured or out-of-network patients facing the full bill for their care.”