Oregon's commercial insurance companies can pay startlingly different rates for the same medical procedure, depending upon which hospital administers care, reports Statesman Journal.
The Oregon Health Authority's most recent report — the Oregon Hospital Payment Report 2014 — uses insurers' reported median costs of reimbursements to Oregon hospitals for 46 common medical procedures. The report lists information from all 36 hospitals and 24 outpatient facilities in the state. Procedures ranged from X-rays to kidney removal to chemotherapy.
Below are four study findings.
1. For 46 common procedures, median prices insurers paid hospitals could more than triple, depending upon which hospital administered treatment.
2. In 2014, gallbladder surgery was the most expensive common outpatient procedure, with an overall median reimbursement rate of $9,029. Out of 36 hospitals listed, Bay Area Hospital in CoosBay charged commercial insurers the highest rates for gallbladder surgeries, at a median of $14,644 per procedure. Grande Ronde Hospital in La Grande charged insurers the lowest rates, at a median of $6,496 over 24 separate cases.
3. Heart valve surgeries were the most expensive inpatient hospital procedures, at a median rate of $74,205 per operation. Out of 36 Oregon hospitals, Good Samaritan Regional Medical Center in Corvallis charged insurers the highest rates for heart valve surgeries, at a median of $85,793 over 15 separate procedures. Asante Rogue Valley Medical Center in Medford charged the lowest rates, at a median of $17,656 over 26 procedures.
4. Oregon Health Authority communications director Robb Cowie told Statesman Journal hospital reimbursement disparities can reflect how many specific procedures hospital staff have overseen, the extent of care each patient requires and whether a hospital-payer contract exists. "Geographic factors play a large role, with a higher cost of living in the Portland Metro Area," Mr. Cowie added.
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