The Hospital Cooperative Charge Comparative

Description

The Hospital Cooperative (THC), a 17-hospital network in southeast Idaho and western Wyoming, completes an annual charge comparative for its members to see how their charges for common items like observation hours and room rates compare to other network members' charges. Hospitals then can use the data to determine if their prices need to be lowered to better compete with other hospitals or if they can raise the price of a certain item to improve their profit margin, instead of raising prices across the board.

Services offered

THC determines which charges to compare, and member hospitals submit their data. The charge comparative looks at charges for popular items or procedures such as:

• Room rates for inpatient, ICU, nursing home, swing bed, newborn, and NICU
• Observation hours
• Physician office visits
• Radiology department services
• Surgery/anesthesia rates
• Lab work
• Procedures

The THC Executive Director collects and summarizes the data. Hospitals receive a report that lists the highest, lowest, average, and median charge for each item or procedure.

Results

THC has offered these annual charge comparative reports since 2010. One hospital posts information on its website when it offers the lowest prices in the region for a specific item or procedure. The information serves as advertising for the hospital as well as price transparency for patients.

Challenges

Explain the value behind the work to gain staff buy-in. There is a fair amount of work for the hospitals to provide their data, but this process only happens once a year. The CEOs and CFOs have always been interested in the summary reports, but sometimes hospitals need several reminders to submit their data on time.

Replication

Seek legal counsel to learn how to best protect private data and prevent antitrust issues. THC's legal counsel told the network to only publish results for a specific item if they had at least five responses for that item.

Decide what you want to measure. THC chose the most popular or commonly used billing items (and in 2020 added three CPT codes related to COVID-19 and antibody testing), but you could also choose the top five Current Procedural Terminology (CPT) codes in each department or you could measure every code, if you wanted a more in-depth report.

Write clear definitions for each measure. THC determined which charges to include and how to define them to achieve apples-to-apples comparison. For example, one hospital might charge anesthesia services per unit or per minute. Another hospital might bundle charges.

Contact Information

Robert Cuoio, Executive Director
The Hospital Cooperative
robert@hospitalcooperative.org