Feds release data on Medicare reimbursements by hospital

Federal data reveals variance in Medicare reimbursements in Knox County hospitals

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Click to enlarge - Comparison of the top eight procedures at Knoxville hospitals. Click to enlarge - Comparison of the top eight procedures at Knoxville hospitals.

By JESSA LEWIS
6 News Reporter

KNOXVILLE (WATE) - The federal government released a huge database of information on Wednesday, shedding light on the rates and procedures performed by hospitals across the country.

The Centers for Medicare and Medicaid Services (CMS) provided figures for the number of procedures performed and the amount that individual hospitals charge for some of the most common medical procedures.

"The question we have now is how can consumers integrate this into the decision making process in getting a procedure done," said former healthcare executive Craig Griffith. "Most people, when they go to a specialist or a cardiologist or an orthopedic surgeon, simply go to that hospital where that doctor has privileges at or is referred to by that doctor."

At the four major Knoxville hospitals - Tennova, Fort Sanders, University of Tennessee Medical Center and Parkwest - joint replacement was one of the most common procedures.

Parkwest Medical Center in West Knoxville charged the least for the procedure at $44,869. The next was Tennova, where patients are billed $45,564.

At UT Medical Center and Fort Sanders Regional, the average bill is thousands more - $48,043 at UT and $49,539 at Fort Sanders.

"There doesn't seem to be a correlation between price and quality. You can go to some places that have a lower price, but who have statistically better outcomes in the given procedures and go to other hospitals that charge more but their outcomes as reported to the Medicare office aren't as good as a lower-priced hospital," Griffith said.

When it comes to treating heart failure with major complications, there is about a $5,000 difference in price.

On average, Fort Sanders charged the least in 2011: $23,102.

Parkwest charged $23,552; at Tennova it was $25,639.

UT charged the most. The bill at UT came in at $30,016.

UT Medical Center Chief Financial Officer Tom Fisher says the results don't account for differences between patients.

"The University of Tennessee Medical Center treats sicker patients with more complex conditions, which increases our cost to provide care. For providing that higher level of care, we receive slightly higher Medicare payments than hospitals not providing that type of care," Fisher said.

The current cost database still may not answer all the questions a patient has.

"You may go into one facility and have certain needs and it's reflected in a different code in a different hospital, so it's difficult to do that apples to apples comparison. But it's the first step down the road in making the consumers more important, letting a consumer or patient actually choose the facility they want to go to," Griffith explained.

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