February 23, 2013

Hospital Chargemaster, Reason for Your Sky-High Medical Bills

Hospital chargemaster, the reason for your sky-high medical bills.

Steven Brill in Time traces the root cause of sky-high hospital bills – the hospital chargemaster.

An example of the sky-high hospital charges from MD Anderson 
Recchi was charged $13,702 for “1 RITUXIMAB INJ 660 MG.” That’s an injection of 660 mg of a cancer wonder drug called Rituxan. The average price paid by all hospitals for this dose is about $4,000, but MD Anderson probably gets a volume discount that would make its cost $3,000 to $3,500. That means the nonprofit cancer center’s paid-in-advance markup on Recchi’s lifesaving shot would be about 400%.
MD Anderson charges $13,702 for an injection that costs it $3,500 – about 4x the cost. Such charges enable MD Anderson to generate a profit of $531million on revenue of $2.05 billion in 2010. These non-profit hospitals sure know how to put the profit in a non-profit.

The justification for the sky-high hospital charges always is because it is in the hospital’s chargemaster. And, according to the hospital’s, the chargemaster charges can never be questioned and they only go up)

You can download California hospital chargemaster to get an idea of the hospital charges. For example, Stanford hospital chargemaster includes 
$450,209.19 charge for PALIVIZUMAB 50MG/0.5ML, service code 33190034.
Palivizumab is a monoclonal antibody used to treat respiratory syncytial virus (RSV) infections.

With your hospital’s chargemaster, you can see how your hospital is going to generate those sky-high bills. The knowledge won’t prevent the hospital sending those sky-high bills but will make you better prepared to negotiate if needed.

The Time article also shows how some people have dealt with the hospital bills.

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