Brooklyn hospitals charge vastly different rates for same procedures

Gov figures released Wednesday

May 9, 2013 By Mary Frost Brooklyn Daily Eagle

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Hospitals across Brooklyn billed drastically different amounts to Medicare for the same procedure, figures released by the government on Wednesday showed. The same billing disparities occurred across the country as well.

While those with Medicare, Medicaid or private insurance may be largely insulated from these price differences, those without insurance – or with high co-payments — may be billed much more for treatment at one hospital than they would at another.

The data released by the federal Center for Medicare and Medicaid Services (CMS) examined the 100 most common treatments at 3,300 hospitals across the country, billed during 2011.

CMS said the data release was part of the Obama administration’s work to make the health care system more affordable and accountable.

For a person receiving treatment for a stroke who also suffers from “multiple chronic conditions” Medicare was billed an average of $32,433 at New York Community Hospital on Kings Highway, but roughly three times as much — $97,668 –at Long Island College Hospital (LICH) in Cobble Hill.

Other Brooklyn hospitals billed between these two extremes for the same condition:
– $34,591 at Woodhull Medical and Mental Health Center in Williamsburg.
– $37,121 at Lutheran Medical Center in Sunset Park;
– $43,399 at Brookdale Hospital Medical Center in Brownsville;
– $45,501 at SUNY Downstate in East Flatbush;
– $47,566 at Kings County Hospital Center in East Flatbush;
– $47,568 at Coney Island Hospital;
– $57,781 at New York Methodist in Park Slope;
– $77,499 at Kingsbrook Jewish Medical Center in Crown Heights;
– $82,993 at Maimonides Medical Center in Borough Park.

Beth Israel Medical Center in Manhattan, by comparison, charged Medicare $77,658 for similar treatment.

In no case did Medicare pay the hospital the full amount billed, and the hospital that billed the most did not necessarily get reimbursed the most.

The average Medicare payment for this treatment ranged from a low of $17,977 at New York Community Hospital, to a high of $33,598 at Coney Island Hospital. (Medicare reimbursed LICH $30,673; and paid Manhattan’s Beth Israel $22,627.)

In another example, charges for “dysequilibrium” (dizziness) in Brooklyn hospitals ranged from a low of $9,259 at New York Community Hospital to a high of $17,442 at Maimonides. Medicare, however, reimbursed New York Community Hospital $8,347, but only paid $7,688 to Maimonides.

Charges for treating chronic obstructive pulmonary disease (COPD) ranged from a low of $9,658 at Kings County to a high of $24,972 at Maimonides. The hospital receiving the highest reimbursement, however, was Kings County, which received $9,854.

The hospital billing process takes into account a number of complex factors – geography, insurance reimbursement issues, the percentage of Medicare and Medicaid patients, whether the hospital is a teaching institution and more.

Bills submitted by profit-making hospitals to Medicare are typically higher than those submitted by nonprofit centers, such as those in Brooklyn, according to the New York Times.

The data also did not address the outcomes of treatment at each hospital -– an important issue to most patients.

Many Brooklyn hospitals, seeing the figures for the first time on Wednesday, felt they could not yet comment on the billing disparities.

Eileen Tynion, VP of Public Affairs at Maimonides told the Brooklyn Eagle, “It’s too soon to comment, but we’re looking into the data and we believe this is a good first step in the direction of transparency.”