Hospitals have also resisted a four-year campaign by the Pacific Business Group on Health, a large employer coalition, and CalPERS to create a “hospital value initiative” that would allow hospital comparison based on and quality of care. “I don’t have a ton of money.”. Doble, 54, says the only reason she went to Sutter was because her doctor chose it for its convenience. Consumers and patients share blame for insisting that their insurance plans include certain hospitals no matter the cost, says John Glynn, an Oakland consultant to the California Health Care Coalition, a group of employers, unions and trust funds. Quality measures for some of the Bay Area’s most prestigious hospitals, including Stanford and John Muir, show that in some instances, less expensive competitors perform as well or better in their basic responsibilities, such as avoiding infections and high death rates for patients in intensive care. “He did it five minutes from his office.”. — Sutter Health is California’s priciest large hospital system. “Nobody should be billed $4,800 for a colonoscopy, this is wrong,” McClung, 56, recalls thinking. Florida ER visit charges for each hospital in 2018. McClung says she had to work hard to get Sutter to change the bill. Nationally, hospital price increases for the privately insured have averaged 4.9 percent a year over the past decade, according to the federal Bureau of Labor Statistics. Schlaegel says so many employees like to see doctors at the Palo Alto Medical Foundation, a doctors’ organization affiliated with Sutter with a clinic right across the Stanford campus, that the university feels obliged to keep offering insurance networks that include Sutter. It found that even people with health insurance pay, on average, more than $1,000 out of their pockets for a hospital stay. In July, Sutter agreed to lower the bill to $1,400 after JustHealth, a Santa Rosa-based advocacy group, helped her protest it, according to correspondence from Sutter provided by Doble. Overall, California acute care hospitals last year collected $28.7 billion from non-governmental sources, principally people who get coverage through their employers. The Henry J. Kaiser Family Foundation Headquarters: 185 Berry St., Suite 2000, San Francisco, CA 94107 | Phone 650-854-9400 Washington Offices and Barbara Jordan Conference Center: 1330 â¦ California requires health maintenance organizations to have “adequate networks” that offer all major specialties reasonably close to where patients live. Let us know at KHNHelp@kff.org, As Hospitals Fill With COVID Patients, Medical Reinforcements Are Hard to Find, How COVID-19 Highlights the Uncertainty of Medical Testing, Amid COVID and Racial Unrest, Black Churches Put Faith in Mental Health Care. In fact, Stanford’s ICU mortality rate and patient satisfaction ratings are below Sequoia’s, though Stanford does better in patient safety, according to CalHospitalCompare. The hospitals haven’t made it easy for consumers to comparison shop. They know purchasers need them. The U.S., followed by Switzerland, had the highest average cost per day to stay in a hospital as of 2015. After four months of negotiations with California Pacific Medical Center, McClung got Sutter to reduce her $4,871 colonoscopy bill. Even With Insurance, A Hospital Stay Will Cost You $1000 or More. $5,700 per MH stay. Filling the need for trusted information on national health issues, The Henry J. Kaiser Family Foundation Headquarters: 185 Berry St., Suite 2000, San Francisco, CA 94107 | Phone 650-854-9400 That was a 37 percent increase from 2005, when hospitals were paid $20.9 billion. Aetna paid $1,483 to San Ramon Regional Medical Center for the same service. Stanford’s own hospital is one of the most expensive in the area — even for routine procedures. Washington Offices and Barbara Jordan Conference Center: 1330 G Street, NW, Washington, DC 20005 | Phone 202-347-5270, www.kff.org | Email Alerts: kff.org/email | facebook.com/KaiserFamilyFoundation | twitter.com/kff. Setting: A total of 253 geographically diverse U.S. hospitals. He says it’s because of “those kinds of services and Stanford kind of being the last stop for people, they need to have us in the network.”. ... costs for an inpatient hospital stay per day ... you can see data for those two states and six other nearby states as well as the U.S. average. Methods: Using Premier's Perspective Comparative Database, supplemented with the MarketScan database, this study estimated the average charges, cost to provide care, and amount of reimbursement for inpatient psychiatric care in 418 community-based hospitals in 2006 (N=261,996 hospitalizations). Stanford pays all the costs of their employee-only coverage for the cheapest health plan it offers, and most of the cost of dependent coverage. The savings amounted to about 3.1 percent of premiums, CalPERS says. Employees who choose a more expensive plan must pay the difference, says Les Schlaegel, Stanford University’s associate vice president for benefits. Stacey Wells, a Sutter spokeswoman, said the hospital couldn’t discuss Doble’s case. If a story is labeled “All Rights Reserved,” we cannot grant permission to republish that item. Getting hospitalized in the U.S. for COVID-19 may cost thousands, researchers say. “That means they’re getting those higher prices without really offering more to patients or the rest of society.”. In many cases, hospitals are able to keep raising prices beyond inflation because their sizes or reputations give them clout in negotiating rates with insurers, researchers say. When you are strategically located, you can say ‘this is our price and you can pay it. Yet Stanford’s basic care isn’t uniformly superior to those hospitals. “His practice is in Antioch,” she says. But Stanford has something nearby competitors lack: an international reputation for sophisticated brain surgeries and organ transplants, bolstered by prestigious faculty at Stanford’s medical school. '”, Sutter officials dispute their rates are unfair or that they have excessive negotiating power. In Simple terms , how sick you are ? Average cost was up about 7.7% from 2017. Hospital executives insist their rates are fair and that there is enough competition among them that if they charge too much insurers and employers can take their business elsewhere. How much of that you'll pay depends on your insurance. In addition, health costs â¦ Check and see where your state ranks: A typical in-patient stay in a hospital is about 5 days, and that may cost you over $10,000.This figure does not include major procedures, ambulance fees, or other charges. The most recent data are from 2013 and reported by Kaiser Health Facts in 2015. Published on January 26, 2017 January 26, 2017 â¢ 42 Likes â¢ 6 Comments The average price of an outpatient visit rose to $728 in 2009 from $505 in 2005. With campuses in Concord and Walnut Creek, John Muir has the biggest footprint in the local hospital market, accounting for 54 percent of all the acute care inpatient stays in 2009, more than any other hospital group, according to state data. Click the button below to go to KFF’s donation page which will provide more information and FAQs. Design: Retrospective cohort analysis using data from NDCHealth's Hospital Patient Level Database. San Ramon ranks equal to John Muir’s Walnut Creek campus in most major measures, including mortality rates in the intensive care units, overall patient satisfaction and maternity care. “They want Sutter, they want John Muir, without any concept or knowledge of what those providers are doing, either in terms of cost or, more importantly, quality.”. “We do certain procedures that are only done in a handful of places in the country,” says Gary May, a Stanford vice president who negotiates contracts with insurers. Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in San Francisco, California. The number of organs which need support. Find the average cost of an emergency room (ER / ED) visit at each Florida hospital in 2018. A coinsurance cost applies after day 60 of the hospital stay. Yet on broad quality measures, John Muir’s hospitals generally score no better than San Ramon does, according to the California Hospitals and Reporting Taskforce, a nonprofit that produces hospital report cards published at Calhospitalcompare.org. California Pacific Medical Center, part of the Sutter Health Network, is in San Francisco. The least Aetna paid John Muir for an uncomplicated birth was $7,722, while the lowest price for a birth at San Ramon was $5,278. Its easy to see how a short stay in the hospital may leave your family in a difficult financial situation. California requires hospitals to publicly reveal more information about their finances than other states do. KHN is an editorially independent program of KFF (Kaiser Family Foundation). John Metz, JustHealth’s executive director, says few people bother to challenge their bills as Doble did. Another employer, Stanford University, has put the onus on its workers. “Sutter basically has a stranglehold on Northern California,” says Schlaegel. Having insurance can help reduce that cost. Yet high prices don’t always equate with superior care. Catholic Healthcare West, another nonprofit chain that is one of Sutter’s main competitors in many Northern California markets, was paid 4 percent below the state average. October 18, 2010. At the other end is San Ramon Medical Center, a Tenet-owned, for-profit hospital, with 10 percent of the acute care inpatients. Hospital rates in the Bay Area now are among California’s most expensive, propelled upward by prominent hospitals and networks, including Sutter Health, Stanford Hospital & Clinics and John Muir Health, according to private and government data. “Some hospitals are able to charge higher prices than the market normally would bear, even without providing higher quality,” says Dr. R. Adams Dudley, a professor of medicine and health policy at the University of California, San Francisco. Adjusting for patient and hospital characteristics, the mean incremental cost of mechanical ventilation in intensive care unit patients was $1,522 per day (p < .001). (The actual colonoscopy was $3,193; there were accompanying charges for supplies, the recovery room and a polyp removal.) He also said John Muir offers more complex and costly services, such as trauma care. “We are not where we want to be at this point in time.”. Range goes up to $8,084 per day. Mary McClung, who lives in San Francisco, was billed $4,871 for a colonoscopy. Median rate is about $1,606 cost per day for a private hospital room. Conclusions: Intensive care unit costs are highest during the first 2 days of admission, stabilizing at a lower level thereafter. An average dayâs worth of care cost 37 percent more than the state average, even more than the University of California hospitals, which see more of the sickest patients. Doble refused to pay and her account was sent to collections. Hospitals must report to the California Office of Statewide Planning and Development how much they collect from insurers, employers and patients. Rochelle N. Doble had a seriously infected toe amputated at Sutter Delta Hospital in Antioch in 2007. “They are strategically situated, both for hospitals and medical groups. Lisa Rubino, president of Molina Healthcare of California, an insurer, says the law makes it difficult for insurers to drop big hospitals from their networks. She said the bill for this kind of procedure would be determined by the number of hours spent in the operating room and recovery areas and charges for all supplies. — Inpatient stays in the East Bay cost 40 percent more than the state average, while all of Southern California, including San Diego and Los Angeles, are below average. Many employers instead make their workers pay the increased costs. The average cost of a 3-day hospital stay is around $30,000. “We believe our payments are appropriate for the quality of care we provide and our ongoing reinvestment in the local community’s health care needs,” he said, adding that John Muir is a nonprofit and does “not generate profits for shareholders or facilities outside of the areas we serve.”. Her doctor told her the bill would be about $1,400, but when she arrived at the hospital, Doble says Sutter told her it didn’t contract with her insurer and that she would be billed for the full amount—more than $5,400. Objective: To quantify the mean daily cost of intensive care, identify key factors associated with increased cost, and determine the incremental cost of mechanical ventilation during a day in the intensive care unit. The Becker Hospital Reviewâs Hospital CFO Report is one of the most valuable sources of information on the actual cost of hospital services. Those are alarming figures, especially for families with limited budgets or no insurance. © 2020 Kaiser Family Foundation. “Most people trust hospitals are going to treat them right,” he says. The average hospital stay costs over $10,000, but the amount varies widely depending on the medical condition. The cost of staying in a public hospital as a private patient follows the same structure as the costs listed above for a private hospital, where Medicare will generally cover 75% of the MBS fee for eligible treatments and your health insurance policy could potentially cover the rest, usually minus an excess (depending on your policy). In California, premiums for families with employer-based coverage grew by an average of 4.6 percent a year between 2005 and 2009, according to the federal Medical Expenditure Panel Survey. Itâs easy to underestimate how much medical care can cost: Fixing a broken leg can cost up to $7,500. Share on Facebook. I suspect these average costs are in â¦ “When they get these bills, they are literally impossible to understand, and people just accept them.”. The California Hospital Association has opposed legislation to ban such “gag clauses”; the most recent of these bills died in the state Assembly in August. firstname.lastname@example.org, The same CT scan in Alabama cost 3k where in Ca is cost 7k. Having health coverage can help protect you from high, unexpected costs like these. SAN FRANCISCO — Soon after her colonoscopy, Mary McClung received a bill from California Pacific Medical Center for $4,871. @JordanRau, By Jordan Rau “But not with health care.”, Related: How KHN Obtained Data For The California Hospital Prices, Jordan Rau: According to Genworth's Cost of Care Survey, on average in the United States, a private room in a nursing home costs $8,365 per month, or $275 a day.For a semi-private room, the average cost of a nursing home is $7,441 per month, or $245 a day. wether you need an expensive antibiotics or a basic one. State law requires hospitals to reveal their charges for specific services. You can support KHN by making a contribution to KFF, a non-profit charitable organization that is not associated with Kaiser Permanente. A stay at the hospital can make for one hefty bill. Thank you! $4,600 per SA stay. We appreciate all forms of engagement from our readers and listeners, and welcome your support. “Collaboration failed, in our view,” says David Hopkins, a leader of the business group. “We have a hard dollar cap (on what we spend), so most of the increases are passed on to our employees and our budget is not hit as hard,” says Richard Rogers, superintendent of Oakley Elementary School District in Contra Costa County. However, when looking at the average cost per hospital stay, heart valve disorders topped the list at $41,878. Average Hospital Cost By State. Commercial insurance comes in at $38,059 per patient, while uninsured cost is listed as $15,792. In 2010, data was collected on the national average and state average cost to stay in a hospital. The average hospital cost for a U.S. patientâs total stay â¦ “I think I had a good outcome, but I think it was just because of persistence and stamina,” says McClung, who lives in San Francisco and organizes people’s homes and offices. CalPERS, the state pension fund, estimates it has saved $252 million over five years by kicking some of the costliest hospitals and doctors — including some of Sutter’s — out of several of its HMO networks in 2005. Consider John Muir Health, a two-hospital nonprofit system in the East Bay. But there are options when it comes to paying for hospital costs. Few employers are willing to limit workers to plans with less expensive hospitals. For privately insured patients, the cost of a stay has increased annually by an average of 8.5 percent over the past five years, while the cost of an outpatient visit has grown by 9.6 percent a year, state records reveal. At that time the hospital costs per day in the U.S. were on average 5,220 U.S. dollars. The weighted average is $23,489. Without insurance, a single night there could cost thousands of dollars. Here’s what we ask: You must credit us as the original publisher, with a hyperlink to our khn.org site. These three cancers also resulted in the longest average lengths of stay: 15.5 days for leukemia, 11.6 days for multiple myeloma, and 10.2 days for non-Hodgkin's lymphoma. May also says Stanford’s higher prices for routine procedures help pay for unique costs, including the expense of training new physicians, but he says Stanford has never used its market power to gouge insurers. Sutter says it agreed to let McClung pay $825 because McClung’s doctor’s office had wrongly told her she would be eligible for a lower rate offered to uninsured patients. The lowest amount the insurer Aetna paid John Muir for an outpatient colonoscopy was $3,185, according to Aetna’s website. California Hospitals: Prices Rising Rapidly, But Quality Varies, Rapid Price Rise At California’s Hospitals, As Hospital System Expands, Patient Advocates Worry, Big Hospitals Dictate Premiums Using Their Clout, How KHN Obtained Data For The California Hospital Prices. State average ER visit cost (charge) was $6,609 (about $60 Billion for over 9 million ED visits). An average day’s worth of care cost 37 percent more than the state average, even more than the University of California hospitals, which see more of the sickest patients. “You have to work with them or make a strategic decision to get out of the area because they can dig in,” says Rubino. “The increases can be devastating to them.”. “You buy a box of nails, the person selling it can tell you the price of it,” she says. Same machine. Are we sure? Nine hospitals had average daily room rates over $7,000 per day: ... with average 9 day stay in hospital), rehab, and many more. Italy Estimates of Unit Costs for Patient Services for Italy. California â Average Inpatient and Outpatient Prices, ... (price) of a PA hospital inpatient room. What kind of infection you have ? $9,300 per stay for all other conditions. “They love their providers,” he says. “The pressure on organizations like ours and others throughout the United States is they are going to have to get much more efficient than they have been in the past,” says Patrick Fry, chief executive officer of Sutter, a large hospital system in Northern California that owns California Pacific Medical Center. Multiple factors affect the overall cost of a nursing home stay. We distribute our journalism for free and without advertising through media partners of all sizes and in communities large and small. Often, a hospital’s dominance in an area helps determine how much it can charge, experts say. For an MRI of the lower back, the least Aetna paid Stanford Hospital was $3,221, twice as much as Aetna’s lowest payment of $1,405 to Sequoia Hospital, a Catholic Healthcare West facility in nearby Redwood City. But those charges don’t reflect the lower negotiated rates insurers actually pay – rates hospitals usually insist be kept secret. Ben Drew, a spokesman for John Muir Health, said in an email that John Muir sees more Medicare and Medi-Cal patients than San Ramon does, requiring other patients to pay more to help cover the costs. Wide Variation by State: The average cost of inpatient hospital stays for mental health or substance abuse disorders vary widely from state to state. Average hospital charges vary widely across the country, with many treatments costing far more in some regions than others. Yet 6 out of 10 employees don’t choose the cheapest policy. A few employers are trying to stop the upward march of hospital prices. The cost of ICU stay depends on the acuity of care needed. Hospital costs averaged $3,949 per day and each hospital stay cost an average of $15,734. If possible, please include the original author(s) and “Kaiser Health News” in the byline. Among the results: Cost per day for hospital charges averaged $3,949 in the U.S., followed by Chile at $1,552. An average day worth of care cost 37 percent more than the state average, even more than the University of California hospitals, which see more of the sickest patients. State laws have inadvertently given hospitals even more leverage. Some pay as much as $5,000 more to buy insurance plans that let them go to doctors and hospitals they choose. However, the highest costs per hospital day were for cancer of the prostate ($4,600 per day), cancer of the breast ($4,100 per day), and cancer of the thyroid ($3,500 per day). U.S. Coronavirus Cases (12/01): 13.721 million, Hospital Adjusted Expenses per Inpatient Day. Thank you for your interest in supporting Kaiser Health News (KHN), the nation’s leading nonprofit newsroom focused on health and health policy. It is not surprising that 60% of all bankruptcies are related to medical expenses. The amount fell within her high insurance deductible, leaving her responsible. Please preserve the hyperlinks in the story. “When we propose alternatives, one of the very first question employers of all sizes ask is what impact the change will have on employees and their dependents,” says Jennifer Walsh, benefits practice leader at Woodruff-Sawyer & Co. in San Francisco. All rights reserved. We encourage organizations to republish our content, free of charge.