Review of CMS Hospital Data for Washington

CMS made national news recently in a surprise release of Medicare data for charges and payments for hospitals around the country. Recently, the Everett Herald reposted the rates for Washington and looked at selected hospitals in King, Snohomish and Skagit counties.

While national headlines have been dramatic, for industry insiders it’s not really much of a surprise.  Medicare rates are low.  Billed charges are not real charges in that they don’t affect actual Medicare payments. And generally, the average patient should not expect this to translate to their bill. As Modern HealthCare put it, “Patients are rarely billed or pay a hospital’s nominal charges. Nor do the charges or their variation indicate the rates hospitals negotiate with insurers.”

Time’s Steven Brill, author of “Bitter Pill“, took to the pages of Time to explain how this new data underscores the mystery of hospital billing.

…most hospitals’ chargemaster prices are wildly inconsistent and seem to have no rationale. Thus the release of this fire hose of data—which prints out at 17,511 pages—should become a tip sheet for reporters in every American city and town, who can now ask hospitals to explain their pricing.

Rather than be commonplace, this data actually probably highlights the ongoing disconnect between “life inside the health care bubble” and the real world paying the bills for that bubble.

Nevertheless, just like we did in Alaska and Oregon we wanted to review rates for Washington hospitals.

We charted payments by Medicare diagnosis for COPD, cardiac arrhythmia and conduction disorders, and pneumonia and pleurisy, at Washington State hospitals (based on available data).

As you can see, the disparities are not as far apart as some of the east coast hospitals in the headlines. And while we do see a few things potentially worth noting, we want to open this discussion up and find out what you think. We offer this site as a platform for anyone who would like to use it to communicate to fellow members of the industry. Post your comments below or even send us a guest editorial. We’d be happy to feature it.