Understanding Hospital Pricing

Regardless of a hospital's charges, the government determines how much the hospital is paid for a service for those enrolled in a federal and/or state program like Medicare or Medicaid. And local negotiations determine how much a hospital is paid by those enrolled in private health plans. The price for services provided is based on many factors that vary from hospital to hospital, including the costs of buying medications, surgical equipment and other supplies; powering and maintaining hospital buildings; paying highly trained healthcare workers; and purchasing up-to-date medical technology.

The best way for patients to determine their out-of-pocket costs in advance of obtaining services is to contact their insurer, whether that is a commercial health insurance company, Medicare or a state Medicaid program. If you do not have health insurance coverage, a financial representative at your Community Health Partners hospital can assist you in obtaining medical benefits through federal, state and hospital programs and can help you determine if you will have any out-of-pocket costs.