A study was released this month that highlighted just how much hospitals can vary in terms of setting costs for their services. The study discussed 50 hospitals that charge patients the most, some up to or over 10 times the actual cost of the service. Just because it highlighted those 50 hospitals does not mean they are the only ones in the country that charge above average they are just the most egregious examples. There are roughly 5,000 hospitals in the country.

HealthAffairs published the report, which used Medicare reports to analyze the top costliest hospitals in the country in 2012. They looked at the costs hospitals took on, things like patient costs and indirect costs such as administration. Then they divided what the total charges were by patient care costs (what Medicare would pay). They found that the highest charge-to-cost ratios in these establishments amounted to 10 times Medicare-allowable costs. The average across the country is 3.4 times these costs. Of the top costliest 50 hospitals, 49 are for-profit and 46 are owned by for-profit healthcare systems.  One single healthcare system, Community Health Systems, owns 25 of the top 50 costliest hospitals. Hospital Corporation of America owns 14.

So what does this mean for you? What does this mean for workers’ comp? The typical insured patient will likely be safe from these inflated costs, since private insurance will pay negotiated rates. Uninsured patients, out of network patients, those going in for auto accident injuries, and workers’ comp patients often pay the full amount these hospitals charge.

Twenty hospitals on the top 50 list are in Florida. Remember that Florida is a state that will reimburse workers’ comp patients on a “percent-of-charges” basis, which means a lot of Florida employers could be getting hit with major charges if they pay a percentage of a larger bill to begin with. Most states have no role in setting hospital rates or regulating what they charge, and it’s not like hospitals are a luxury expense that people are going to be willing to go without. They can charge what they want because people need medical care and will pay for it, there is really no competition or cheaper alternative.

Hospitals on the list say that the results skew the reality of the situation, and that their charges do not really reflect what patients pay. They said they give discounts to those who qualify and those discounts were not included in the charge-to-cost conclusion the researchers came up with.