Home > Finance & Reimbursement > Price Transparency Requirements

Q  Why do some people on Medicare pay a different amount for the same procedure than others?
A Each provider has different operating costs. For example, a hospital that serves a large number of uninsured patients and is also a certified teaching hospital, which means it trains residents, will have much higher operating costs than a hospital that does not have a training program or has a limited amount of patients who are unable to pay their bills. Those higher operating costs are ultimately reflected in the price of care for Medicare-covered procedures. Another explanation for cost variation among Medicare enrollees is based on the type of Medicare health insurance. For instance, Medicare Advantage Plans, offered by private companies such as health maintenance organizations (HMOs) or preferred provider organizations (PPOs), often have different prices when compared to traditional Medicare plans since they are negotiated by private companies.

Return to the full list of hospital price transparency questions.


Join our distribution list to receive our monthly Quick Scan which features our recent news and upcoming events.

+ Subscribe