Most Expensive Colorado Hospitals Set Charges From 10 to 13 Times Over Their Costs

Colorado Hospitals Massively Overcharge

A new study released this week shows that the most expensive Colorado hospitals jack up their charges by as much as 10 to 13 times their costs, posing a significant burden for patients.

 

With the Covid-19 pandemic continuing to explode across the country, the study from National Nurses United documents how high hospital charges are accelerating a national health care crisis for patients and families. The potential of the Supreme Court overturning the Affordable Care Act adds to this threat.

 

“There is no excuse for these scandalous prices,” said NNU President Jean Ross, RN. “These are not markups for luxury condo views, they are for the most basic necessity of your life: your health. Unpayable charges are a calamity for our patients, too many of whom avoid the medical care they need due to the high cost, or become mired in devastating debt, hounded by bill collectors or driven into bankruptcy.”

 

Nationally, U.S. hospitals charge on average $417 for every $100 of their costs, a markup that has more than doubled the past 20 years, the report notes. It is based on publicly available Medicare cost reports for 4,203 U.S. hospitals in fiscal year 2018, the most recent data available. The full report is available at  https://act.nationalnursesunited.org/page/-/files/graphics/1120_CostChargeRatios_Report_FINAL_PP.pdf

 

High hospital charges also drive Covid-19 treatment costs. One study of claims data found that average charges for a Covid-19 patient requiring an inpatient stay can range from $42,486 with no or few complications to $74,310 with major complications.

 

If the ACA is thrown out by the Supreme Court, the 23 million people in the United States who either buy insurance through the ACA exchanges or are covered by the expansion of Medicaid would lose coverage, the New York Times recently reported.

 

Further, as many as 133 million people in the country under age 65 who have preexisting conditions, plus the 11 million people, and counting, infected by Covid-19, would all once again be subject to insurance denial for coverage, and higher out-of-pocket costs.

 

In Colorado, according to the national study, the most expensive hospital in the state is North Suburban Medical Center in Thornton, which has a charge-to-cost ratio of 1,302 percent —  in other words, it charges $1,302 for every $100 of its cost.  Rounding out the top five are Sky Ridge Medical Center in Lone Tree, Swedish Medical Center in Englewood, The Medical Center of Aurora, and Rose Medical Center in Denver.

 

How high hospital charges affect patients’ health and safety

 

Hospitals sometimes maintain that the charge master price, essentially a list price to bargain over reimbursements from insurers, does not reflect how much insurers actually pay since negotiations between insurers and hospitals are confidential, the report notes.

 

However, a 2017 study found that for each additional dollar increase in a list price, insurers paid an additional 15 cents to hospitals. Hospital executives have conceded that the goal of the charge master is profitability. And when the insurers pay more, their cost generally is passed along to employers or individual patients in higher premiums, deductibles, and co-pays.

 

Uninsured patients have the least negotiating power when hit with the full charge, a major reason why medical bills have sparked a huge rise in medical debt lawsuits. Once the hospitals win a favorable court judgment, they often next file liens against patients’ homes, or garnish their bank accounts or wages. Increasingly, hospitals sell the debt to bill collectors to hound patients.

 

The national scandal over surprise medical billing also drives up costs, and harm, for patients, often through charges for insured patients who are then billed for “out-of-network” providers even when receiving care at an “in-network” hospital. Studies have found as many as four of every 10 ER trips result in surprise medical bills, with hospitals sharing the higher profits.

 

While some hospitals maintain they lower those charges for these patients, or help patients by providing charity care, hospitals have reduced the amounts of financial assistance and charity care offered to patients around the country.

 

Medicare is the most effective system at limiting inflated pricing practices through its bulk power to set the price it is willing to pay. “Nurses know that the best way to rein in these outrageous charges that create so much harm for our patients is with Medicare for All, as other countries have proven,” said Ross.

 

“Medicare for All will not only guarantee health coverage for every American, it will end medical bankruptcies, medical debt lawsuits, and the health insecurity faced by millions who make painful choices every day whether to get the care they desperately need,” Ross said.

 

Guerin Green