“How Much Will I Get Charged for This?” Patient Charges for Top Ten Diagnoses in the Emergency Department

Abstract

ObjectivesWe examined the charges, their variability, and respective payer group for diagnosis and treatment of the ten most common outpatient conditions presenting to the Emergency department (ED).MethodsWe conducted a cross-sectional study of the 2006–2008 Medical Expenditure Panel Survey. Analysis was limited to outpatient visits with non-elderly, adult (years 18–64) patients with a single discharge diagnosis.ResultsWe studied 8,303 ED encounters, representing 76.6 million visits. Median charges ranged from $740 (95% CI $651–$817) for an upper respiratory infection to $3437 (95% CI $2917–$3877) for a kidney stone. The median charge for all ten outpatient conditions in the ED was $1233 (95% CI $1199– $1268), with a high degree of charge variability. All diagnoses had an interquartile range (IQR) greater than $800 with 60% of IQRs greater than $1550.ConclusionEmergency department charges for common conditions are expensive with high charge variability. Greater acute care charge transparency will at least allow patients and providers to be aware of the emergency department charges patients may face in the current health care system.

The Effect of an Educational Intervention on Alcohol Consumption, At-Risk Drinking, and Health Care Utilization in Older Adults: The Project SHARE Study

“…The Project SHARE intervention itself required signifi cant resources, primarily the "opportunity cost" of health educator and physician time; adding another patient to the intervention was calculated to require $110 in screening plus intervention costs. However, during the same period, the median charge for outpatient emergency department visits was $1,233 (Caldwell et al, 2013), suggesting that the estimated reduction in emergency department visits alone might cover screening and intervention costs. Although a full analysis of cost-effectiveness is outside the scope of the current study, reductions in health care utilization re- Notes: n = 1,073 for 6-month outcomes and n = 1,049 for 12-month outcomes.…”

Current concepts on the pathophysiology and management of recurrent ankle sprains and chronic ankle instability

“…The strain on the health care system in the form of medical and productivity expenses adds to the indirect cost of ankle sprains. Caldwell et al [2], identified ''sprains and strains'' as the most common outpatient condition in the United States with 4.4 million emergency department visits per year. Nearly half of all ankle sprains occur during athletic activity (49.3 %) [3].…”

Two Wrongs Do Not Make a Right: Flaws in Alternatives to Fee-for-Service Payment Plans Do Not Mean Fee-for-Service Is a Good Solution to Rising Prices Comment on "Fee-for-Service Payment - An Evil Practice That Must Be Stamped Out?"

“…First, because of the interplay of government regulators, insurance companies, and several (often conflicting laws) the prices are completely non-transparent. 8 For example, a hospital might have a listed charge for a service (say, inserting an artificial knee) of $35 000, but the various insurance companies will actually pay $4000, and the copays from individual patients will vary from $100 to $31 000. 8,9 Moreover, there will be additional fees from the anesthesiologist (with the same range of costs and payments), for operating room time, etc.…”

“…8 For example, a hospital might have a listed charge for a service (say, inserting an artificial knee) of $35 000, but the various insurance companies will actually pay $4000, and the copays from individual patients will vary from $100 to $31 000. 8,9 Moreover, there will be additional fees from the anesthesiologist (with the same range of costs and payments), for operating room time, etc. In fact, most hospital bills are incomprehensible even to experts, and many are often flat out wrong.…”

“…In fact, most hospital bills are incomprehensible even to experts, and many are often flat out wrong. 8,9 Professor Ikagami raises many excellent points and is undoubtedly well-intended and knowledgeable about many national health systems. His critique of non-FFS systems is spot on.…”