The Centers for Medicare and Medicaid released their data on hospital pricing.
Some of the sticker prices in West Michigan for certain hospital procedures may surprise you.
The Spectrum Health family includes hospitals and facilities in Grand Rapids at the Butterworth campus, and also facilities in Greenville, Zeeland and Fremont.
You might think that the costs for a procedure at all of the facilities are the same.
However, the details of the newly released report says they are different.
We broke down the costs of being treated for heart failure with major complications at Spectrum’s facilities and Bronson’s facilities.
At Spectum’s Butterworth campus in Grand Rapids, the cost was the highest listed price within the Spectrum family, at more than $ 20,117.
At the Zeeland facility, the cost was $17,340 for the same procedure.
In Greenville, the price was a bit less expensive at a listed, $15,142.28.
Fremont’s price tag was listed at $13,499.39
Along the I-94 corridor, the sticker price at Bronson’s two facilities was also different.
In Kalamazoo, the price tag is $28,097.01 for treating heart failure with complications while at the Battle Creek facility, the sticker price is $17,083.36
A spokesperson for the Michigan Health and Hospital Association said there are a number of factors that make hospital costs different within the same hospital family.
“Patient severity, the payer mix, investments in new technology, labor, what they have to pay for the salaries and benefits of those who care for the patients in that hospitals,” said Lee.
And, the different hospitals also had different pricing in the West Michigan community.
We checked out bronchitis and pneumonia and heart failure with major complications to compare pricing between hospitals.
Bronson in Kalamazoo came out on top for sticker pricing for each of those procedures.
For heart failure treatments with major complications, Bronson’s sticker price in Kalamazoo was $28,097.01 compared to a much lower listed price of $13,033.70 at Saint Mary’s Hospital in Grand Rapids.
For treating Bronchitis and asthma without major complications, the price was listed at Bronson in Kalamazoo at $13,041.08 while Spectrum Butterworth in Grand Rapids was charging $9,301.39 and Pennock Hospital in Hastings was charging $8,054.31.
For treating pneumonia Pleurisy without major complications, Bronson Methodist in Kalamazoo’s sticker price is $15,646. While Metro Health in Wyoming is charging $7,602.50 for a sticker price. Spectrum Butterworth’s listed price is $9,307.92.
Although the sticker prices seem high, it doesn’t mean that’s what you or your insurance company will pay.
For many of the institutions, rates are negotiated. That means different insurance companies can agree to pay for different percentages of the costs and larger health institutions can negotiate better deals under some circumstances.
In the newly released government data, Medicare paid only an average percentage of the cost.
For example, at Spectrum Butterworth in Grand Rapids, the sticker price for heart failure with complications was $20,117.19. However, medicare only paid out on average $11,390. for the procedure.
And, at Bronson in Kalamazoo, for the $28,097.01 sticker price, medicare only paid on average $11,504.51.
“Hospitals are required to charge the exact same amount for the exact same procedure. Let`s say you and I have the exact same procedure done and you have medicare and you have a payer, medicare would pay a different rate and insurers would pay a different rate depending on what they negotiated with that hospital,” said Lee.
For a look at what your provider is charging for a sticker price, check out the link below:
Here is a comparison of pricing within the facilities in the Bronson and Spectrum families for one procedure:
SPECTRUM FACILITIES/Heart Failure treatment with major complications
Spectrum Group, Grand Rapids: $20,117
Spectrum Group, Zeeland: $17,340
Spectrum Group, Greenville $15,142
Spectrum Group, Fremont $13,499
Bronson Medical Facilities/Heart Failure treatment with major complications
Bronson Group, Kalamazoo $28,097
Bronson Group, Battle Creek $17,083
Spectrum did issue us a response as to why pricing might be different at each of the facilities in their health care family. This is the statement below:
The CMS site lists charges. That’s like the list price. We would encourage people to go to our website to view average net prices. http://www.spectrumhealth.org/AveragePrices
We also encourage people to always call their hospital before a test or procedure to check cost and what their co-pay may be.·
It is not unusual for our hospitals to have different cost structures. Each community hospital does have a different cost structure due to their unique services, expenses, payor mix and also their volume.
Teaching (Spectrum Health Grand Rapids) vs. rural hospital costs are very different. The overhead of running a very small inpatient hospital has to be paid for in outpatient prices (because there are fewer inpatients to allocate overhead to) in a rural hospital.
This is a big challenge for all small hospitals in the U.S.
Transparency in health care is important. We feel employers and consumers need to be aware of health care charges and should not hesitate to ask hospitals and physicians for pricing information.
Spectrum Health is dedicated to delivering high-quality care at a low cost. In 2006, Spectrum Health was among the first health systems in the country to begin posting average prices on the web. We have to enhanced our listings and now include average payments from private and public sources.
Priority Health, our insurance entity, also is a leader in posting payment information. They are laying the groundwork to become the first health plan in Michigan to publish specific, regionalized health care costs and quality information by procedure, facility and physician.