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Expand chart
Data: JHU; Chart: Will Chase/Axios

Some of the hospitals with the highest revenue in the country also have some of the highest prices, charging an average of 10 times more than the actual cost of the care they deliver, according to new research by Johns Hopkins University provided exclusively to Axios.

Why it matters: Hospitals each determine their own charges, or list prices. While few patients ever pay those prices, due to negotiated insurance rates, they do affect the uninsured and, experts say, ultimately influence the overall price we all pay.

Details: Johns Hopkins University researchers looked at the overall cost-to-charge ratio listed in the American Hospital Directory for the top 100 hospitals in the U.S. by their 2018 revenue to calculate the average markups.

  • Of the top 100 largest hospitals in the U.S., 57 were charging more than five times the actual cost, on average, of the care they provided.
  • Nine hospitals were charging more than 10 times the actual cost.
  • The hospital with the highest average markup was HCA's Chippenham Hospital in Richmond, with charges at nearly 13 times its cost.
Data: JHU; Chart: Will Chase/Axios

For-profit hospitals had the biggest markups. They made up nine of the 10 hospitals with the biggest markups, and eight of those for-profit hospitals charged more than 10 times their costs.

  • But, a majority of the 57 hospitals with a markup of five times or higher were non-profit hospitals (34).
  • Pennsylvania and Texas were among the states that stood out when it came to markups. Nine of the top 15 were located in one of these two states.

The other side: Hospitals said this sort of calculation can be misleading, in large part due to the fact that few ever pay the actual chargemaster price.

  • "We have some of the most comprehensive policies and programs in the healthcare industry to protect our patients from financial hardship," said Cheri Love-Moceri, a spokeswoman for Methodist Hospital, referring to charity care programs and "uninsured discount" programs.
  • "Hospitals and health systems do more than any other part of the health care field to support vulnerable patients," said an American Hospital Association spokesman, adding hospitals provided more than $702.51 billion in uncompensated care to patients since 2000.

Go deeper: Explore the full Axios-Johns Hopkins analysis

Go deeper

Sep 8, 2021 - Health

Idaho begins rationing medical care amid COVID surge

Kootenai Health hospital in Coeur d'Alene, Idaho. Photo: Don and Melinda Crawford/Education Images/Universal Images Group via Getty Images

Idaho will begin rationing medical care in 10 of the state's overburdened hospitals in two districts, its Department of Health and Welfare announced Tuesday.

Why it matters: The move comes as the state has seen a "massive increase in patients with COVID-19 who require hospitalization" compounded by a shortage of beds and equipment, amid a surge driven by the Delta variant, per a news release.

Tina Reed, author of Vitals
Sep 9, 2021 - Health

COVID cases hold steady while hospitalizations, deaths rise

Data: N.Y. Times; Chart: Kavya Beheraj/Axios

New coronavirus infections held steady across the U.S. as falling case rates in a few hot spots in the South were offset by increases elsewhere.

Driving the news: While the overall COVID case rate increased less than 1% over the last two weeks, hospitalizations increased 4% in the same time frame, and the seven-day rolling average of deaths rose 29%.

Updated 9 hours ago - Politics & Policy

Omicron dashboard

Illustration: Brendan Lynch/Axios

  1. Health: Pfizer and Moderna boosters overwhelmingly prevent Omicron hospitalizations, CDC finds — Omicron pushes COVID deaths toward 2,000 per day — The pandemic-proof health care giant.
  2. Vaccines: The case for Operation Warp Speed 2.0 — Starbucks drops worker vaccine or test requirement after SCOTUS ruling — Kids' COVID vaccination rates are particularly low in rural America.
  3. Politics: Biden concedes U.S. should have done more testing — Arizona says it "will not be intimidated" by Biden on anti-mask school policies — Federal judge blocks Biden's vaccine mandate for federal workers.
  4. World: American Airlines flight to London forced to turn around over mask dispute — WHO: COVID health emergency could end this year — Greece imposes vaccine mandate for people 60 and older — Austria approves COVID vaccine mandate for adults.
  5. Variant tracker