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Two private El Paso hospitals rank nationally for costs
Other area hospitals make another 'high-cost ratio' list
By: Joshua Zuber
EL PASO, Texas -- According to National Nurses United, Las Palmas Medical Center charges 854 percent above cost.
That means, on average, for each $100 of their cost, they are reportedly charging about $854 on a patient's bill.
Sierra Medical Center also made that list.
Their cost, according to this new data, says Sierra charges on average $820 for every $100 of their costs.
National Nurses United gets the billing information based on reports the hospitals file with Medicare, according to Chuck Idelson, a spokesperson for the group.
Las Palmas Medical Center's Melissa Offutt sent KFOX14 the following statement on this study: "Las Palmas Medical Center's first priority is to provide accessible, quality healthcare to the people of El Paso in the most efficient and cost-effective way possible.
"This study does not take into account the full scope of hospital charges, of which all hospitals are paid and collect a significantly reduced portion, in relation to the complex hospital reimbursement structure.
"Additionally, what patients are charged doesn't equate to what patients actually pay. Insured patients pay only a percentage of charges based on a negotiated, discounted payment rate with insurers. Charges to uninsured patients who do not qualify for charity are discounted to the same managed care insurance rates. Most indigent patients qualify for a 100 percent charity discount.
"The amount hospitals in a market like El Paso, with a large uninsured population, have to charge is sometimes greater because those charges, once discounted to insurers, have to subsidize the care of the larger population that has no resources.
"In 2013 Las Palmas Medical Center provided about $90 million in uninsured, charity care and discounted patient charges, all of which represent uncompensated care costs.
"The hospital will continue to invest in patient care and quality, as evidenced by our recent recognition as a Top Performer on Key Quality Measures from The Joint Commission, in the most efficient and cost-effective manner."
As for Sierra Medical Center, a representative sent KFOX14 the following message:
The data on hospital charges does not accurately reflect the amount our hospital receives for providing healthcare to any patients. We carefully examine every aspect of our operations to improve efficiency, cut unnecessary expenses, and prioritize spending on what matters most positive outcomes for our patients and improved health for our region.
Hospital pricing is often confusing and complex, and we join the federal hospital associations in acknowledging that, as an industry, we must evolve toward a system that makes accurate information about the cost of care easily accessible by patients; however, it would be a mistake for any consumer to choose a provider based upon this CMS data.
Hospitals receive payments for Medicare patients based on rates that are set annually by federal law; Medicaid payments are set by each state; and patients with private health coverage pay amounts based on the rates negotiated by their insurance provider.
For the uninsured and direct pay patients, we provide discounts comparable to those negotiated by insurance plans. Our policy on pricing for uninsured patients is set forth in our Compact With the Uninsured, which we adopted in 2003 becoming one of the first hospital systems to provide comprehensive discounted pricing for uninsured patients.
For patients who have insurance coverage, the best place to start is with their insurer, who can provide an accurate estimate of their out-of-pocket cost based upon their specific plan. We also will always work to provide an accurate estimate of the cost up front for patients and to earn their business based on the high quality care and value we provide.
Two hospitals in Las Cruces also made a National Nurses United list.
Representatives at Mountain View Regional did not make a statement or provide interviews as KFOX14 requested Friday in time for this story to be published.
Memorial Medical Center released the following statement:
"Charges are not the same as what hospitals are actually paid by government or commercial payers or consumers who are uninsured.
"The Medicare and Medicaid programs reimburse hospitals based on the patients diagnosis. Medicare unilaterally determines what it will pay hospitals; often, the payments do not cover the actual cost of providing care. Commercial insurers negotiate discounts for their subscribers.
"All patients meet with our trained financial counselors who can provide payment options for any portion of the hospital bill not covered by insurance. These counselors work with uninsured patients to determine eligibility discounts from charges, financial assistance, Medicare, Medicaid, or charity care. We understand the financial aspects of healthcare can be confusing and our staff is always willing to explain billing or insurance benefits for patients.
"Like most hospitals, we provide medically necessary emergency care for all patients, regardless of their ability to pay. Our hospital provides millions in uncompensated care each year."
National Nurses United sent these rankings to KFOX14 in an email: In New Mexico, which ranks 19th in the U.S., Mountain View regional (for profit Community Health system) is seventh-highest in the state with a charge to cost ratio of 483 percent and Memorial Medical Center is ninth-highest in the state with a ratio of 415 percent (they charge $415 for every $100 in costs)