UNDERSTANDING HEALTH CARE

Experts get to the heart of growing costs in York County

In just six years, the average charges for various procedures and medical conditions have more than doubled at York County hospitals.

MORE COVERAGE:

Annual hospital performance reports are released in an effort to contain health care costs and improve the quality of care Pennsylvania's patients receive.

The Pennsylvania Health Care Cost Containment Council, an independent state agency, was formed in 1986 to produce those reports and address rapidly growing health care costs, said spokeswoman Stephanie Suran.

The council's strategy is to stimulate competition in the health care market by providing information about the most efficient and effective health care providers.

Health care providers are encouraged to use the reports to identify opportunities to contain costs and improve the quality of care they deliver, she said.

Officials at each hospital in York County agreed the hospital performance reports are reviewed annually to help measure the quality of care offered at their facilities.

Criticism: However, one official at Memorial Hospital said the charge data listed on the report are "irrelevant" and "meaningless" to the hospital.

"You could take the report and look at it and say, 'I should go here because their charges are less,' but that isn't true and is not a valuable report," said Sally Dixon, president and chief executive officer of Memorial.

Charges reflect the number of resources used on each particular patient and are also a method for tracking use of the hospital's resources, said Dixon.

"The charges have nothing to do with what we're paid or what patients will ultimately owe us," she said.

For example, she pointed out the open gallbladder removal category on the hospital performance reports.

Under this category, all of the procedures are representative of the typical traditional gallbladder removal, said Suran.

However, some of the procedures may remove the entire gallbladder and some may remove only a portion of the gallbladder, as patients undergoing these procedures may have varying degrees of gallbladder disease, said Suran.

In 2003, charges for the different procedures that fell in that category ranged from $5,800 to $153,000.

With such a dramatic range in charges, fewer or more procedures performed during the 12-month time period could skew information for year-to-year comparisons, said Dixon.

Mere indication: The average hospital charges reported by PHC4 are merely an indication of what consumers without health insurance might pay and what some insurers who reimburse hospitals based on a percentage of charges would pay, said Suran. Because PHC4 does not know what goes into each hospital's charges, it's uncertain whether it's safe to compare the charges among the different hospitals, she added.

York Hospital, for instance, is a trauma center that by its very definition deals with the most serious cases, said spokesman Barry Sparks.

As a result, more patients are likely to die or experience costly, long stays at York Hospital.

Each year, York Hospital officials review all of the report's results very seriously, Sparks said.

And in addition to the PHC4 reports, similar internal reports are also conducted to ensure high quality care with contained costs, he said.

-- Reach Lauren Whetzel at 505-5432 or lwhetzel@yorkdispatch.com.

Reading the reports

Each September, the Pennsylvania Health Care Cost Containment Council (PHC4) releases a hospital-specific performance report divided into three regions, outlining each treatment and procedure's average charge, readmission rate, length of stay and mortality ratings.

The council collects more than 4.5 million inpatient hospital discharge and ambulatory/outpatient procedure records each year from hospitals and freestanding ambulatory surgery centers across Pennsylvania.

The hospital-specific data include hospital charges and treatment information such as readmission, length of stay and mortality ratings as well as other financial data. The information is collected on a quarterly basis, verified by PHC4 staff and then released in annual reports.

Hospital and health provider reports are available to the public at www.phc4.org.