ACO Medicare Provider Inpatient Payment Data

Medicare Provider

Medicare Provider Inpatient Payment Data Released

CMS has released  Medicare Provider payment data. CMS released the data at the direct request of the Obama Administration at an attempt to increase transparency between consumers and providers.  The data they released is from 2011 and you can download the data for free off of their website. The information they specifically released is inpatient and outpatient charges. Below is what ACOs charged chest pain patients.

Insurance ACO

Dartmouth-Hitchcock / Cigna
53 discharges
average charge = $12,378
average total payment = $5,114.15

Hoag Memorial / Blue Cross Blue Shield
18 discharges
average charge = $18,669
average total payment = $3,498

Montefiore / Blue Cross Blue Shield
494 discharges
average charge = $23,857
average total payment = $6,818

New York Presbyterian / Cigna
491 discharges
average charge = $15,573
average total payment = $6,313

Norton Hospital / Humana
255 discharges
average charge = $18,069
average total payment = $3,735

Non-Insurance ACO

St. Thomas (Nashville TN)
59 discharges
average charge = $11,604
average total payment = $3,046

Non ACO

Vanderbilt
40 discharges
average charge = $14,136
average total payment = $4,522

Gateway Medical Center (Community Health Systems)
129 discharges
average charge = $14,607
average payment = $3,347

 

Above is information on Medicare Provider Inpatient payment data. As you can see, these providers charge Medicare a lot for the services that they provide but they do not get much back (reimbursement) in return.

Matthew Taber is Chief Operating Officer of Direct Care For Me (www.directcareforme.com), which provides full access to medical care to patients and  100  percent reimbursement to primary care physicians through direct primary care (no insurance necessary) models. Low cost health insurance for business owners and employees. On site health care for employees. Exclusive savings on x-rays, labs, surgery, specialty office visits. See a doctor (family practitioner, internist, ob/gyn, pediatrician) anytime on your smartphone tablet, or computer (telemedicine). Reach him by e-mail at matthew at direct care for me dot com or by phone at 615-669-8347 to sign up today.  

This entry was posted in Hospital and Medical Practice Management and tagged , , , , . Bookmark the permalink.

Leave a Reply