Does Media Attention Highlighting Hospitals with High Charges Lead to Charge Reductions?

Karoline Mortensen, Ph.D., Tianyan Hu, Ph.D., Steven G. Ullmann, Ph.D., Michael T. French, Ph.D.


Background: The identification of the 50 hospitals in the US, including 20 located in Florida, with the highest charge-to-cost ratios in 2015 was met with significant public outcry.

Objective: To compare the total charges in the 20 high charge-to-cost ratio hospitals in Florida before and after media attention and public scrutiny to trends in total charges in the other hospitals in the state.

Research Design: We use difference-in-differences analysis to analyze 1,027,091 discharges from acute care hospitals in the state of Florida (n=206) between quarter 3 of 2010 and quarter 3 of 2015. Models account for discharge characteristics, and hospital and quarter fixed effects.

Measures: Total charges, adjusted by the 2015 Consumer Price Index for Medical Care, by hospital for commercial and self pay patients is the main outcome variable. Trends in total charges were assessed before and after publication of the 20 top charge-to-cost ratio hospitals in Florida.

Results: Our analysis finds no evidence that hospitals responded to the publicity with any meaningful reductions in charges. Charges in the third quarter of 2015 were significantly higher than charges in previous quarters.

Conclusions and Relevance: As hospital charges continue to rise and the best path forward to address price transparency continues to elude policy makers and stakeholders, it is important to recognize that hospitals may not respond quickly to public exposure and these initiatives. 

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