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Extreme Markup: The Fifty US Hospitals With The Highest Charge-To-Cost Ratios. Bai, Ge 1 ; Anderson, Gerard F 2 1 Ge Bai ([email protected]) is an assistant professor in accounting at

Washington and Lee University, in Lexington, Virginia. 2 Gerard F. Anderson is a professor in the

Department of Health Policy and Management and the Department of International Health at the Johns

Hopkins Bloomberg School of Public Health, in Baltimore, Maryland. . Health affairs (Project Hope)

 Vol. 34, Iss. 6,  (June 2015): 922-928.

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ABSTRACT Using Medicare cost reports, we examined the fifty US hospitals with the highest charge-to-cost ratios in 2012.

These hospitals have markups (ratios of charges over Medicare-allowable costs) approximately ten times their

Medicare-allowable costs compared to a national average of 3.4 and a mode of 2.4. Analysis of the fifty hospitals

showed that forty-nine are for profit (98 percent), forty-six are owned by for-profit hospital systems (92 percent),

and twenty (40 percent) operate in Florida. One for-profit hospital system owns half of these fifty hospitals. While

most public and private health insurers do not use hospital charges to set their payment rates, uninsured patients

are commonly asked to pay the full charges, and out-of-network patients and casualty and workers' compensation

insurers are often expected to pay a large portion of the full charges. Because it is difficult for patients to compare

prices, market forces fail to constrain hospital charges. Federal and state governments may want to consider

limitations on the charge-to-cost ratio, some form of all-payer rate setting, or mandated price disclosure to regulate

hospital markups. FULL TEXT _TVM:UNDEFINED_ DETAILS

Journal classification: Index Medicus

MeSH subject: Insurance, Health; Medicare -- economics; United States; Economics, Hospital

(major); Hospital Charges (major); Hospital Costs (major)

Supplemental data: Comment In:; BMJ. 2015; 350:h3285 [26080091 ]

Identifier (keyword): Financing Health Care, Health Economics, Hospitals

Correspondence author: Bai, Ge  

Publication title: Health affairs (Project Hope)

Journal abbreviation: Health Aff (Millwood)

Volume: 34

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Issue: 6

Pages: 922-928

Number of pages: 7

Publication year: 2015

Country of publication: United States

eISSN: 1544-5208

Source type: Scholarly Journals

Format availability: Internet

Language of publication: English

Record type: Journal Article

Publication history :

   Accepted date: 15 Dec 2016

      Revised date: 30 Dec 2016

   First submitted date: 10 Jun 2015

DOI: http://dx.doi.org/10.1377/hlthaff.2014.1414

Update: 2019-02-06

Medline document status: MEDLINE

PubMed ID: 26056196

ProQuest document ID: 1687348103

Document URL: http://access.library.miami.edu/login?url=https://search.proquest.com/docview/168

7348103?accountid=14585

Last updated: 2019-02-13

Database: Biological Science Collection

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