Datapalooza: HHS Unveils Medicare Outpatient Costs

Scott Mace, for HealthLeaders Media , June 4, 2013

Healthcare cost data released by the federal government Monday includes estimates for average hospital charges for 30 types of outpatient procedures.

The Obama administration made government transparency a campaign promise and on healthcare data it is delivering in a big way.

On Monday, Medicare data including estimates for average charges for 30 types of hospital outpatient procedures was released. This follows the release last month of pricing information data for the 100 most common Medicare inpatient DRGs or diagnostic related groups.

Health and Human Services Secretary Kathleen Sebelius Monday announced the availability of inpatient costs at the beginning of Health Datapalooza IV, the fourth annual national conference on health data transparency. The conference is "born from government efforts to liberate health data" and brings together government agencies, private companies and academics to improve healthcare.

The data released by the Centers for Medicare & Medicaid Services includes county-level data on Medicare spending and utilization for the first time, as well as selected data on hospital outpatient charges. In addition, the HHS Office of the National Coordinator for Health Information Technology released additional information on the adoption of specific electronic health record systems.

"A more data-driven and transparent health care marketplace can help consumers and their families make important decisions about their care," Sebelius says. "The administration is committed to making the health system more transparent and harnessing data to empower consumers."

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1 comments on "Datapalooza: HHS Unveils Medicare Outpatient Costs"

flpoggio (6/7/2013 at 7:09 PM)
"Why does it look like this? Why is it so crazy? Same reason I gave in an earlier post. In case you missed it: Yes hospital charges are non-sense, all over the map, not based on logic, etc. All true. But how'd that happen. As a former CFO I can tell you it was all done via the Medicare Cost Report, the core basis of Medicare payment system. For almost five decades the government has used the Cost Report, and a myriad of other convoluted reimbursement systems, to calculate payments to hospitals. So over the decades any good CFO would make sure that his charges maximized his governmental payments. And Medicare and Medicaid usually make up 60% of the total payments. Some fifty years ago charges became a substitute for statistics and cost accounting to estimate how much the government was going to pay you. Ever hear of RCCAC? That's the Ratio of Costs to Charges as Applied to Costs, a key calculation in the Cost Report. One of the most insane ways of 'identifying' costs ever cooked up. And it's still used today! Hospitals get paid based on DRGs, but still must do a Cost Report to justify the DRG amounts. I was around in 1983 when the feds came up with DRGs, they said back then the DRG system would replace the Cost report...and here we are 30 years later- with both! If you want to know why charges are a mess...just look at the Cost Report, and ask who created that monster? Maybe CMS should release a 'history' of CMS??




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