Compare Hospital Charges
In 2007, the Minnesota Hospital Association made public the charges for the
top 50 inpatient Diagnosis Related Groups (DRGs) and the top 25 outpatient
surgical procedures. Beginning in 2014, when data for 2013 was released, MHA expanded its Hospital Price Check website and now makes public all inpatient DRGs. A note of caution: these are not prices that a person with
insurance should expect to pay. First, these charges are an average of what the
hospital charges all payers – commercial insurers, Medicare and Medicaid.
Second, it does not include charges for the physician or other professional
fees, such as pharmacy, diagnostic imaging, or lab work.
These
reports can help you compare overall charges among regional health care
providers, but, as stated above, should not be used as an estimate for what you
will have to pay.
When comparing recent data released by
the Centers for Medicare & Medicaid Services for the top 100 Diagnosis Related Groups, Minnesota’s charges are 6 percent below the national average.
That means our charges are relatively low compared to other states. In
addition, when looking at the variation of average charges from high to low
charges, Minnesota’s inpatient hospital charges show considerably low variation
among hospitals.
Definitions
When discussing
hospital pricing, understanding a common set of definitions is important. Cost,
charge, and price are not interchangeable terms:
- Cost varies by the party (the consumer, insurer, health care provider)
incurring the expense.
- Charge is the dollar amount a health care
provider (your hospital, physician or clinic) sets for services rendered before
negotiating any discounts with a payer (the insurance company).
- Price is the total
amount a health care provider expects to be paid by payers and patients for
health care.*
*Definitions provided by the Healthcare Financial Management Association,
April 2014.