Monday, March 28, 2011

Cost of medical procedures across Lone Star State vary w i d e l y

From The New York Times
by Texas Tribune writer Emily Ramshaw

The cost of common medical procedures paid for by Medicaid — the joint state-federal health care program for indigent children, the disabled and the very poor — varies dramatically by hospital and region, according to a Texas Tribune analysis of claims by and payments to hundreds of hospitals statewide.

A routine delivery at St. Luke’s The Woodlands Hospital costs Texas Medicaid twice as much as at Christus St. Catherine Hospital in Katy, just 50 miles away. The Harlingen Medical Center bills Medicaid nearly $5,500 less for a coronary bypass than does the Laredo Medical Center, though both hospitals are along the Texas-Mexico border. The disparity is the result of a payment formula that gives each Texas hospital its own rate. State health officials, seeking ways to curb Medicaid costs and address the concerns of hospitals on the lower end of the payment spectrum, have proposed a single base rate for all hospitals — with a variety of allowances for expensive-to-operate facilities.

Such a formula, they say, would save Texas, which faces an enormous budget shortfall, an estimated $74 million over the next two years — and up to $2.8 billion if lawmakers set the rate at the bare minimum.

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