Case Management

CMW News: Hospitals receive different reimbursements for identical procedures

Case Management Weekly, November 26, 2008

Some Massachusetts hospitals earn much higher rates than other hospitals in the state for performing the same procedures, even though no proof exists that the care is better, The Boston Globe reports.

Insurance companies such as Blue Cross Blue Shield of Massachusetts and Harvard Pilgrim Health Care pay certain facilities 15% to 60% more than other hospitals on average, and sometimes even twice or three times as much for individual procedures, such as an angioplasty.

For example, Anna Jaques Hospital in Newburyport, MA, earns $75 for a chest x-ray while Massachusetts General Hospital in Boston earns $160 for the same.

The Globe says this process is usually kept under wraps because of confidentiality agreements between hospitals and payers. The newspaper called for more regulated healthcare policies to prevent reimbursement disparities from happening further.

Source: The Boston Globe

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