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WENATCHEE — If you think your bill from Central Washington Hospital or Wenatchee Valley Hospital was high, think again.
In 2011, the average charges at both hospitals for the most common procedures were lower when compared with some 3,000 hospitals across the country, according to data released last week by the federal government. For the seven procedures offered at Wenatchee Valley Hospital — which is at the Wenatchee Valley Medical Center — charges were about half that of average, the data shows.
Billing data released by Centers for Medicare & Medicaid Services shows a huge discrepancy in the average charges for the top 100 most frequently billed inpatient procedures across the country. Smaller hospitals in the region, from Omak to Leavenworth, were not included.
Only 7 of the procedures were offered at Wenatchee Valley Hospital.
But at Central Washington Hospital — where most of the 100 procedures were listed — billings ranged from 30 percent to 90 percent of average bills across the country. In no cases were they equal to or higher than the average bills.
A top official for both medical facilities said that’s largely because the hospitals do not raise their rates to compensate for lower reimbursement rates from Medicare or Medicaid, or negotiated reimbursements from insurance companies.
“I think what both institutions have tried to do is make it more in line with the actual cost of providing the care,” said Dr. Peter Rutherford, CEO of Confluence Health, which oversees both hospitals.
“You can write a bill for anything you want,” he added. But what a hospital gets paid is often based on a percentage of the bill that the hospital negotiates with individual insurers, or that is offered by Medicare or Medicaid.
That system leaves people who have no insurance paying the highest rates, unless hospitals charge for actual costs, Rutherford said.
He said both hospitals in Wenatchee have also tried to limit yearly increases in costs to the general inflation rate.
Another reason for Wenatchee’s lower cost may be that wages in this area — including those for healthcare professionals — tend to be lower than other areas that support major hospitals that are on the list, he said.
The release of this data offers proof that the Wenatchee Valley Medical Center’s hospital is not a typical “boutique” or “specialty” hospital, which came under fire by Congress a few years ago, Rutherford said. In 2008 and 2009, Congress considered several bills that would have eliminated Medicare and Medicaid reimbursements to all physician-owned hospitals, seen to cherry-pick the more lucrative procedures, and leave the more difficult and riskier cases to nonprofit hospitals.
“I think all along, it has looked at itself as a community-based medical service, and has acted more like a nonprofit than a for-profit,” Rutherford said.
But there are differences in the charges between the physician-owned Wenatchee Valley Hospital, and Central Washington Hospital.
Overall, Wenatchee Valley Hospital charged less for the same procedure than Central Washington Hospital, the data shows. For example, the average cost of a major joint replacement at Central was $40,890, while at Wenatchee Valley Hospital, it was $24,619.
That difference, Rutherford said, is largely because the more serious cases end up at Central Washington Hospital.
“No two individuals having the same illness or surgery are the same,” he said. So a patient who needs a certain procedure, and has complications of diabetes and heart failure will likely have the procedure done at Central Washington Hospital, where there is an intensive care unit. The same procedure could be done safely on an otherwise healthy person at Wenatchee Valley Hospital, without the need for an ICU, he explained.
Rutherford said in addition to leaving out reasons for the cost differences, a cost comparison is missing another important factor. “You don’t want to just look at the price. You want to look at the quality of care you get,” he said. “With the outcome data we have for care in Wenatchee, we certainly are at the national median, or a little better. And, we’re able to do that at a little lower than the average cost.”
K.C. Mehaffey: 997-2512