Wednesday, October 08, 2014

Medicare patients at critical access hospitals paying much higher rates than at other hospitals

Medicare beneficiaries treated at critical access hospitals "end up paying between two and six times more for outpatient services than do patients at other hospitals," says a report released Wednesday by the inspector general at the U.S. Department of Health and Human Services, Jordan Rau reports for Kaiser Health News.

"Medicare requires patients to pay 20 percent of the amount a critical access hospital charges," Rau writes. "At other hospitals, patients also pay 20 percent coinsurance, but it is based on the amount Medicare decides to reimburse the hospital, which is almost always significantly below what the hospital charges." For example, in 2012 a Medicare patient receiving an electrocardiogram at a critical access hospital owed an average of $33, while patients at other hospitals paid $5, and critical access hospital patients getting an initial infusion into a vein had to pay $56, compared to $25 at other hospitals.

"The inspector general’s office recommended Congress change the law so that a Medicare beneficiary’s financial responsibility better reflects the cost of the service," Rau writes. (Read more)

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