Hospital costs uneven in eastern Idaho

The cost for the same procedure can vary greatly from hospital to hospital — even in eastern Idaho.

The federal government just released its Inpatient Charge Data summary for fiscal year 2011. In it, you’ll find three of eastern Idaho’s hospitals — Portneuf Medical Center, Eastern Idaho Regional Medical Center and Madison Memorial Hospital — and you’ll find their cost of procedures.

“Not every case takes the same amount of time,” said Jeff Biocco, chief financial officer at Eastern Idaho Regional Medical Center.

Here’s a brief look at the average bill charged for joint replacement surgery:
Portneuf: $41,000
EIRMC: $55,000
Madison Memorial: $29,000

Why is there such a big difference? Both Madison Memorial and EIRMC had the same answer.

“Every hospital is different, and they have costs they have to cover,” said Cecil Ricks, chief financial officer at Madison Memorial Hospital.

“More resource intense services such as the NICU, or trama center are going to be higher than more routine services just as medical care,” said Biocco, of EIRMC.

The resources they use, length of stay, the severity of the surgery — all these play a part in a hospital’s average bill charge.

But most of the time, you won’t have to pay the total bill.

“It’s a matter of negotiating. Every hospital negotiates and tries to get the best reimbursement, and insurance get the lowest reimbursement,” said Ricks.

However, for Medicare patients, the U.S. government uses what’s called the diagnosis-related group. It determines the amount of reimbursement a provider or hospital will get based on the type of diagnosis in a certain area. That’s why Medicare reimbursement is somewhat close in all three hospitals in easter Idaho.

Also by law, providers and hospitals cannot bill a patient for the difference lost from the reimbursement, a policy called balanced billing.

Despite the differences in costs, Idaho still has one of the lowest cost of medical procedures in the country.

Portneuf Medical Center did not get back to Local News 8 in time to comment.

To view the report, go to http://goo.gl/s3xJa.