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June 11, 2015 at 06:55 AM
If you’re seeking medical treatment at North Okaloosa Medical Center in Crestview, FL, and you don’t have health insurance or if the center is out of your network, beware. You’ll pay full price at the hospital that marks its services up more than any other hospital in America.
And some markups represent a 1,000 percent markup on some services and procedures, compared to what Medicare is willing to cover for those services.
At least that’s the word from researchers at the Johns Hopkins Bloomberg School of Public Health and Washington and Lee University. They did a study of health care center price markups based upon 2012 price lists and churned out the Top 50 health centers with the highest markups over accepted Medicare prices.
The 50 hospitals in the United States with the highest markup of prices over their actual costs are charging out-of-network patients and the uninsured, as well as auto and workers’ compensation insurers, more than 10 times the costs allowed by Medicare,” the researchers said in a release. “The combination of a lack of regulation of hospital charges in the United States and no market competition is leading to price-gouging that trickles down to nearly all consumers, whether they have health insurance or not, and plays a role in the rise of overall health spending.”
Pretty dire stuff. Now, these price lists, known as chargemasters, are more guides to charges than fixed prices for services. The hospitals on the list have pointed out in the past that they don’t often stick to list prices, dipping below for those with insurance and those who are in the network.
But, according to Reuters, these health centers do charge the full price for auto-insurers, those without insurance, and out-of-network care seekers.
“There is no justification for these outrageous rates, but no one tells hospitals they can’t charge them,” says study co-author Gerald Anderson, a professor in the Bloomberg School’s Department of Health Policy and Management. “For the most part, there is no regulation of hospital rates and there are no market forces that force hospitals to lower their rates. They charge these prices simply because they can.”
