By Michaela Gibson Morris/NEMS Daily Journal
TUPELO – Northeast Mississippi hospitals largely came in under national averages for hospital charges in data published by the Centers for Medicare and Medicaid last week.
In many cases, the average charges for common procedures like joint replacement, pneumonia and gall bladder removal were tens of thousands dollars below the highest reported charges in the state during the 2011 fiscal year.
“For us it is intentional for us to hold prices down,” said Joe Reppert, chief financial officer for North Mississippi Health Services, the parent organization for NMMC.
North Mississippi Medical Center-Tupelo, Baptist Memorial Hospital-North Mississippi in Oxford and OCH Regional Medical Center in Starkville all came in under the national amount, and often under the Mississippi averages for charges billed to Medicare in Fiscal Year 2011.
“It doesn’t surprise me,” said Richard Hilton, administrator and chief executive for OCH Regional. “Our board has been very community-minded to keep our itemized charges as low as possible.”
Magnolia Regional Medical Center’s charges came in right at the national average and largely just above the Mississippi average. However, its charges were still significantly lower than highest charges in the state. Magnolia chief executive Rick Napper said his team was still analyzing the data to see if it’s accurate.
“It doesn’t match the data we typically look at,” Napper said.
Regardless of the level of hospital charges, Medicare paid hospitals at far lower rates than it was billed. The reimbursements, which are based on diagnosis, don’t vary as much as the hospital charges, which reflect the procedures, treatments, medicines, materials and days in the hospital for patients.
The Medicare data was published in an effort to bring more transparency to hospital pricing and reimbursement rates. But the data won’t be much help to patients who want to shop around, especially if they have insurance.
“Most everything is a fixed fee,” based on diagnosis, said David Barham, vice president for financial operations for Baptist Memorial Health Care.
The hospital charge database at data.medicare.gov is most helpful to those without insurance who don’t qualify for charity care, but it is incomplete because most hospitals now offer significant discounts to self-pay patients.
“It’s a good start, but it only gets you to first base,” Reppert said.
There’s wide variation in hospital pricing – $26,000 to $101,000 in Mississippi for an uncomplicated total joint replacement. But it can come not only from the differences in each hospital’s charge structure, but also in the mix of patients for that particular diagnosis during that year.
“They could have been squeezed by a couple of bad cases,” where patients stayed in the hospital for weeks instead of days, Reppert said.
For more details on hospital charges and medicare reimbursements check out today’s NEMS Daily Journal newspaper.