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.”
All but one of the Top 50 were for-profit health centers, the report said. Half of those on the list were affiliated with the major for-profit health companies Community Health Systems Inc. and Hospital Corp. of America, and 20 of the hospitals were in Florida.
“For-profit hospitals appear to be better players in this price-gouging game,” said co-author Ge Bai, an assistant professor of accounting at Washington & Lee University. “They represent only 30 percent of hospitals in the U.S., but account for 98 percent of the 50 hospitals with highest markups.”
The researchers estimated that as many as 30 million uninsured Americans are likely to be charged the full rate.
Check out the top 10 hospitals that engage in this price game.
Taking a slice from the list, here are the Top 10 Marker-uppers, as ranked by the researchers:
North Okaloosa Medical Center (FL)
Carepoint Health-Bayonne Hospital (NJ)
Bayfront Health Brooksville (FL)
Paul B Hall Regional Medical Center (KY)
Chestnut Hill Hospital (PA)
Gadsden Regional Medical Center (AL)
Heart of Florida Regional Medical Center (FL)
Orange Park Medical Center (FL)
Western Arizona Regional Medical Center (AZ)
Oak Hill Hospital (FL)
Read more detail on the study and find the list of the Top 50, at the Johns Hopkins Bloomberg School of Public Health site. Their full report is published in the June issue of Health Affairs.