Region’s hospital expenses in line with Colo. average

A woman having a baby in Northern Colorado can expect to be in the hospital 1.4 days and receive a hospital bill for about $2,500. If she ends up having a Caesarean, she’ll be in the hospital 3.3 days and pay between $5,100 and $6,923. Her newborn will bring home a bill for about $1,000.If you’re in need of a hip replacement, you’ll be in the hospital about five days and pay in the neighborhood of $18,000, while a bout of bronchitis that lands you in the hospital for 2.5 days can set you back close to $4,000.
These are just a few of the statistics about Northern Colorado hospitals found in the Colorado Hospital Association’s ninth annual report titled, “1995 Hospital Charges and Average Length of Stay for the Most Common Reasons for Hospitalization (By Severity of Illness).”
The top 10 reasons for hospitalization in 1995 included: birth, vaginal delivery; newborn care; simple pneumonia and pleurisy; uterine tumorous cancer (hysterectomies, etc.); birth, Caesarean delivery; heart failure and shock; hip and partial hip replacement; other back and neck procedures (including spinal-cord procedures); other digestive system disorders (including intestinal infections caused by bacteria, parasites and food poisoning); and bronchitis and asthma.
In the report, hospital admissions are grouped by illness or disease through a system called All Patient Refined-Diagnosis Related Groups. This system allows categories of illness to be analyzed by how sick the patient is, allowing for better understanding of the patients treated by each hospital, according to Peg O’Keefe, vice president of public affairs and education for the CHA, based in Denver.
The 1995 report includes the reasons for hospitalization, ranks them according to severity (minor, moderate, major and extreme), lists the number of patients, average length of stay as well as the shortest and longest stays, and the average charge along with the lowest and highest charges.
How do Northern Colorado hospitals look in this report? Average. In fact, perhaps one of the most noticeable things in this report is how, more or less, the hospitals are in line with one another in terms of length of stays and costs.
“Sometimes, average isn’t a bad thing,´ said Dan Palmquist, vice president of finance for Longmont United Hospital.
There are some differences, however. At North Colorado Medical Center in Greeley, for example, the hospital is well under the state average for Caesarean delivery – $5,160 for NCMC, $7,555 for the state, but almost $5,000 more than the $18,936 statewide charge for hip and partial hip replacements.
Gene Haffner, director of communications and community relations for the Western Plains Health Network, which includes NCMC, McKee Medical Center and East Morgan County Hospital, said a couple of factors are behind both of those nonaverage charges.
“While we can’t pinpoint one specific cause (for NCMC’s low Caesarean charge), our efforts in training and utilization of staff seems to help,” Haffner said. He explained that the hospital’s birth center staff is cross-trained, the same team follows the new mother from admission to discharge, and the operating room staff is specialized in performing the required surgery.
The higher hip replacement charge, he said, is due to the demographics of the patients who have the procedure. They are older, many are on Medicare, and they come from not only Northern Colorado, but Wyoming and Nebraska as well.
“Because they’re from outlying areas, their length of stay here is longer,” Haffner said.
A number of factors can affect your hospital bill. First, demographics. The older the population, the more Medicare cases there are.
“We’re very high in Medicare, and the reason for that is the age of our population,´ said Andy Will, chief executive officer at Estes Park Medical Center. And because of that, Estes Park’s Medicare average of patient days – 56.4 percent – is considerably higher than the rest of Larimer County (53 percent at McKee and 44.5 percent at Poudre Valley).
And the higher the Medicare/Medicaid population, the less the hospital is paid, according to Peg O’Keefe. “A hospital with a high number of Medicare or Medicaid patients must charge other patients more to recover the costs not paid for by these government programs.”
The two government-funded and administered programs accounted for more than half of the hospital days statewide in 1995.
O’Keefe also noted, however, that a limited number of patients pay the exact charges billed. In addition to reduced costs for Medicare/Medicaid, insurance groups contract with hospitals for lower rates. In 1995, 26,400 out of 387,722 inpatients and 15,170 out of 259,663 outpatients were listed as “self-pay.”
In Colorado, overall expenses for providing inpatient care rose only two-tenths of a percent from 1994 to 1995, according to O’Keefe.
“Managed care has had a very powerful impact for the need of hospitals to operate very efficiently,” she said. “There’s a lot of scrutiny on the quality and cost of the care. This benefits the consumer.”
The information provided in this annual report, she added, gives the consumer the opportunity to be in a stronger position when discussing his or her health care. “The consumers who are active and outspoken do better than passive patients. That’s why we’ve included a section on asking questions of the hospital and physician.”
O’Keefe also noted that this report is possible only because Colorado is one of just three states where such information is made available – voluntarily – by the state’s hospitals. The CHA sends a copy to all academic and public libraries as well as to the news media and legislators who request them.
“This is one measure, one piece of information we can collect,” O’Keefe said.
Dan Palmquist at Longmont United Hospital, said that the report provides all hospitals with a benchmark.
“Benchmarking is important for all of us to do a better job. If we’re benchmarking against the state, and our average stay is one or two days longer (than the statewide average), than a flag goes up, and maybe we need to look at it, maybe there’s something we could do better that makes more economical sense and better care.”
Palmquist noted that the way hospitals are approaching health care today is different than even 10 years ago. It used to be, he said, the sicker the people in a community, the better the hospital did. Now, hospitals approach their business from the standpoint of the healthier the community, “the better we do.”ÿ