Hospitals Analysis

2 min read

Noteworthy things:

  1. Hospital fines went from max of 100k per year to $2M per year for not publishing chargemaster (Jan 2022)

  2. The Wall Street Journal reported in March that hundreds of hospitals had embedded code in their disclosure webpages that kept them from being indexed by the search engines.

  3. Under the new rule from CMS, penalties can go as high as around $2 million a year for large hospitals that fail to make prices public. That is a sharp increase from the $109,500 maximum a year per hospital under existing rules. For hospitals with 30 or fewer beds, penalties remain the same.

  4. Even within an insurance plan, prices aren’t consistently low or high. A plan’s prices for one service can be among the lowest a hospital negotiates, but among the highest for another, the Journal’s analysis found.

  5. The Journal compared Avera McKennan’s 2019 PET CT price for Ms. Kingsbury with the price Medicare would pay, as calculated by price-comparison startup Turquoise Health Co. The hospital’s cash price for Ms. Kingsbury in 2019 was 5.7 times the Medicare rate, according to the Journal’s analysis using newly public data collected by Turquoise. That’s one of the highest multiples of any of the more than 1,200 U.S. hospitals in the analysis.

  6. Do certain payers pay lower prices than others (systematically)? Like who gets the best deal?

  7. Can we create a database of codes that people can use?


  1. string matching on payers



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