See What Elmhurst Memorial Hospital Billed Medicare for Common Procedures

When a patient arrives at Elmhurst Memorial Hospital needing major joint replacement, the hospital bills Medicare $66,385. A few miles west, , bills Medicare $50,651 for the same treatment, according to a massive federal database of national health care costs the Centers for Medicare & Medicaid Services made public Wednesday. 

The data shows that what hospitals bill to Medicare varies—sometimes dramatically—from hospital to hospital. Hospitals say the reason for the higher bills could be because they treated sicker patients or they are teaching hospitals, according to an article in The New York Times.

The data also shows that what hospitals bill is up to 20 times more than what Medicare reimburses. Medicare has a standardized system of payment, private insurance negotiates the balance of coverage with hospitals, and the patient may pick up the rest. Those without private insurance are likely to be hit the hardest, according to the New York Times.

On average, Elmhurst Memorial bills Medicare 1.2 to 1.4 times more than the U.S. average, while Edward Hospital's bills for common procedures range from .8 to 1.2 times the U.S. average. Edward's stent insertion procedure is the exception, at 1.6 times the national average, according to the New York Times searchable database. 

For the first time, people can see in detail how much the vast majority of American hospitals charged for the top 100 most common procedures billed to Medicare. The database covers claims filed within fiscal year 2011 and includes 163,065 individual charges recorded at 3,337 hospitals in 306 metropolitan areas, Huffington Post reported. 

Illinois hospitals on average charged about the same as the national average for procedures, such as major lower joint replacement, pneumonia, breathing problem with ventilator, chest pain and heart failure, according to the database compiled by Washington Post, which is searchable by state. 

The University of Chicago Medical Center and Gottlieb Memorial Hospital had some of the highest prices for treatments among Chicago-area hospitals in 2011, according to Crain’s Chicago Business. 

Here’s a look at how much Elmhurst Memorial charged for common treatments compared to other nearby hospitals: 

Treatment

Hospital Name       

Number of Cases

Avg. Amount Billed Medicare

Avg. Amount Paid by Medicare

Major Joint Replacement

Elmhurst Memorial Hospital

268

$66,385

$14,929

Advocate Good Samaritan

308

$59,299

$14,259

Edward Hospital

367

$50,651

$13,854

Drug-coated stent insertion

Elmhurst Memorial Hospital

$12,895

Advocate Good Samaritan

68

$78,192

$14,751

Edward Hospital

101

$99,963

$16,854

Permanent Pacemaker Insertion

Elmhurst Memorial Hospital

$73,036

$12,224

Advocate Good Samaritan

30

$58,730

$12,231

Edward Hospital