Health & Medicine

Cost of care varies greatly at Lexington hospitals, data shows

St. Joseph East Hospital on North Eagle Creek Drive
St. Joseph East Hospital on North Eagle Creek Drive Lexington Herald-Leader

Costs for various types of major medical care at Lexington hospitals — including treatment for heart attack, joint replacement and kidney failure — varied wildly in data provided by the federal government this week.

The numbers, released by the Centers for Medicare and Medicaid Services, gave American consumers their first look inside the pricing structures of hospital stays, figures often seen for the first time when a bill arrives.

Lexington hospital officials said that consumers should approach such figures warily because of the complexity of the pricing models and the fact that consumers do not pay "sticker price" for their medical procedures.

In Lexington, treatment for renal failure was priced at $23,561 at the Saint Joseph East Hospital and $50,024 at the University of Kentucky Chandler Hospital. The prices for gallbladder surgery were much more similar between the city's three health care giants: Baptist HealthCare (formerly Central Baptist), the two Saint Joseph hospitals and UK's Chandler Hospital.

The Herald-Leader sorted the data, and readers can go online to see the costs for five common medical concerns. While most patients will not pay the amount listed for each illness or procedure, the numbers serve as a base rate off which private insurance, Medicare or Medicaid will determine what they will pay.

Lexington hospital officials were asked to respond about how consumers should view the numbers:

Kristi Lopez, spokesman, UK Chandler Hospital: "It is more appropriate to compare costs at UK with those at other academic medical centers such as Vanderbilt and Ohio State University rather than at community hospitals.

"Overall, when evaluating similar health care providers, UK's focus on efficiency measures has resulted in our costs being very comparable to other academic medical centers across the U.S. Academic health centers support the tri-fold mission of education and research in addition to clinical service which often factors into and impact cost."

Ruth Ann Childers, spokeswoman, Baptist Health Lexington (formerly Central Baptist Hospital): "Caution is advised in interpreting this information. This information is based on Medicare inpatients only. A Medicare beneficiary has the same inpatient deductible per benefit period, currently $1,184, regardless of which acute care hospital provides their care.

"For patients who are uninsured, and don't qualify for government assistance, or need services not covered by insurance, the best course of action is to contact the financial counseling office at the facility in which they are seeking treatment and ask what the average charge is for the service they need and the amount of self-pay discount they would be eligible for.

"Benefits vary so widely with commercial insurance plans, for example, deductibles, co-pays, out-of-network costs, provider contracts, that this chart is of little relevance."

John Smithhisler, president, Saint Joseph Hospital; Central and Eastern Kentucky market leader, KentuckyOne Health: "As the state's largest health care provider, and largest provider of care to the uninsured, KentuckyOne Health supports the transparency of this information. It's another tool we will use to help break down barriers to access care and improve the health of all that we serve.

"While charges rarely reflect what any provider is actually paid, variations often give insight into a hospital's mission and patient population. Twenty-four/seven emergency care, specialty services, the training of physicians and other health care professionals, research, and a high number of uninsured patients all impact the establishment of charges."

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