Local births among most costly in Colorado

Southwest Memorial among top 10 for Medicaid billing

Southwest Memorial ranked in the top 10 among hospitals in Colorado for sending Medicaid the most expensive bills for natural and Caesarean births, according to recently released data.

The Center for Improving Value in Health Care recently released data on the cost of hip and knee replacements and births at hospitals across the state. The payment information came from Medicaid and 16 insurance companies.

The public database available at comedprice.org shows major differences in 2012 medical bills across the state. For example, Southwest Memorial Hospital charged an average of $4,500 – between Medicaid and the patient’s co-pays – for a natural birth. This price made it the eighth-highest in the state out of 48 hospitals. St. Mary Corwin in Pueblo, the cheapest in the state, charged about $3,400.

Bills for those on Medicaid having a Caesarean birth showed a similar trend. At Southwest Memorial, the average price excluding outliers was about $7,700, which made it the fourth most expensive out of 45 hospitals. At the low end, was Poudre Valley Hospital in Fort Collins, which charged Medicaid and the patient $4,700.

For Southwest Memorial Hospital, there was no data available on how much it would charge for a woman with insurance to have a baby. There was also no data on hip or knee replacements. The center only included price points for those hospitals that submitted data for 11 or more procedures in each category.

While big differences in the amount charged for Medicaid services do not impact the patient’s wallet, there is an impact on taxpayers who fund the state-managed Medicaid.

Jonathan Mathieu, the director of data and research, said the center plans to share the data with the state and it made lead to some “tough questions” for those hospitals charging the most for Medicaid services.

Liz Sellers, the interim CEO of Southwest Memorial Hospital, did not respond to requests for comment before press time.

The center also examined of the illness burden upon hospital’s on a county-by-county level because it can impact price. A healthy community places less a pressure on the services and keep costs lower.

Montezuma County has an illness burden of about 9 percent higher than average, and this could be skewed by just a few complex cases, Mathieu said.

The center is also working to expand the database to include 2013 data, payment information from outpatient clinics and more procedures such as colonoscopies, arthroscopic knee surgery and mammograms. The center is targeting procedures that patients plan out ahead of time and can now shop for through the database for the first time.

“We are steering clear of the very emergent situations,” said Alicia Goroski, the director of performance measurement, with the center.

However, as more companies offer health saving plans rather than traditional insurance, this information is becoming vital, Goroski said. Medicine is one of the few industries in which consumers seek out services having generally no idea what they are going to cost at the outset.

“It’s our goal over the next year or two to kind of lift the veil,” she said.