The price of inpatient admission: What is it? And when is admittance appropriate?
The recent $97-million settlement between Tennessee-based Community Health Systems and the Department of Justice has put the spotlight on inpatient expenses. The hospital system is alleged to have inappropriately admitted patients in order to bill Medicare at the higher inpatient rates. CHS has denied any wrongdoing, and the blame, according to CEO Wayne Smith, lies with "shifting and often ambiguous standards" that make it "extremely difficult" for hospitals to comply with inpatient regulations.
"The question of when a patient should be admitted to a hospital is, and always has been, a matter of medical judgment by the individual physician responsible for a patient's care," said Smith in a statement.
Admitting patients is, of course, expensive, and has come under the increased price scrutiny facing the healthcare industry. And across services, payers and patient advocates alike are examining the extreme price variation in medical care. That variation is especially apparent in inpatient expenses.
But reimbursement aside, what does it cost hospitals to admit a patient? Healthcare Dive takes a look at the operating and non-operating expenses of inpatient admission for hospitals on a state-by-state basis.
Editor's Note: Data represents operating and non-operating expenses for registered U.S. community hospitals. Expenses have been averaged across state/local government hospitals, non-profit hospitals and for-profit hospitals. Per Kaiser Family Foundation, adjusted expenses per inpatient day include expenses incurred for both inpatient and outpatient care; inpatient days are adjusted higher to reflect an estimate of the volume of outpatient services. It is important to note that these figures are only an estimate of expenses incurred (by the hospital to provide a day of) inpatient care and are not a substitute for either actual charges or reimbursement for care provided.