Joint replacement: $117,000 — or $26,000?

September 17, 2013

By Mike Waldron, Ted Keefe and Lee Francis

Some Virginia hospitals charge far more than others for the same procedure, according to data recently released by the federal Centers for Medicare and Medicaid Services.

For example, CJW Medical Center in Chesterfield County charged an average of more than $117,000 for a major joint replacement – the most common in-patient surgical procedure in Virginia. In contrast, Winchester Medical Center in northwestern Virginia billed less than $26,000 for that surgery.

Henrico Doctors’ Hospital charged an average of almost $398,000 to treat an infectious or parasitic disease. Martha Jefferson Hospital in Charlottesville billed about $53,000 for that treatment.

And John Randolph Medical Center in Hopewell charged an average of about $41,000 to treat someone suffering from heart failure and shock. At Augusta Health medical center in Fishersville, the average charge for that procedure was just $8,191.

The figures come from a database released in May by the federal agency that operates Medicare, the health insurance program for Americans 65 and older, and Medicaid, a similar program for low-income Americans.

The data show what hospitals charged in fiscal year 2011 for the 100 most common in-patient procedures. The database contains information on more than 3,000 hospitals throughout the United States.

Medicare pays far less than the amount the hospitals charge. (For a major joint replacement, for instance, the government agency pays a hospital about $13,000.) But insurance companies and uninsured individuals may find themselves facing the much higher amounts that hospitals charge.

The wide disparities in hospital charges for medical treatments in Virginia reflect a national trend. A Washington Post analysis of the data found a “tremendous, unexplained variation in cost of services.” Even on the same street in the same city, one hospital might charge four times more than another hospital for the same procedure, The Post reported.

Data journalists at VCU found some differences in Virginia even bigger than that.

For instance, Virginia Hospital Center in Arlington charged an average of less than $60,000 to treat septicemia or severe sepsis, a whole-body inflammation that is caused by severe infection and can be fatal. But Henrico Doctors’ Hospital charged six times as much to treat that diagnosis — more than $372,000.

The federal government is releasing the data for the first time to increase transparency in the health care system. The next task at hand remains: to determine what the numbers mean and their true relevance or value. After all, the nation’s health depends on it.

Search the data showing what Virginia hospitals charge

This article is a “Data Drop brief” — a quick-hit posting based on analysis by students in MASC 644 Computer-Assisted Reporting. The exercise involved downloading data from a federal government website and then filtering and sorting it with Excel.