Most adult emergency department patients are charged between 1 and 12.6 times what Medicare pays for the same services, according to a recent Johns Hopkins study of Medicare billing records.
Researchers from Baltimore-based The Johns Hopkins University — led by Tim Xu, MD, of the Johns Hopkins School of Medicine — studied excess charges related to emergency care service payment claims made by CMS in 2013. The claims included services provided to Medicare Part B fee-for-service beneficiaries by more than 12,000 emergency physicians at more than 2,700 hospitals.
Researchers found emergency medicine physicians had an average markup of 340 percent in excess charges, which were "substantially higher than those in the internal medicine department for the same services." Comparatively, all services provided by internal medicine physicians had an average 110 percent markup.
The study also found higher ED excess charges were associated with hospitals owned by for-profit companies, hospitals with a larger share of uninsured patients and geographical location.
Study authors concluded "further legislation is needed to protect uninsured and out-of-network patients from excess charges in the emergency department."