Case Study: Having a procedure performed in a hospital (inpatient) versus an outpatient facility has greater implications than you might think.
Gall bladder removal surgeries are one of the most common procedures performed in the U.S. today. Overwhelmingly, there is a perception that an inpatient procedure is preferable over one performed in an outpatient facility. To determine whether the consensus is justified, MAP® reviewed 28,766 gall bladder removals to discover the percentage of procedures performed inpatient versus outpatient, the difference in charges for procedures performed in each facility, the average length of inpatient stay, and the complication rates for these surgeries in seven markets.**
What Does This All Mean?
In 2012, an average of 41% of the gall bladder removal procedures performed in these markets were done in an outpatient setting. The number of such procedures performed in outpatient facilities varied wildly, from only 9% in New York City and Pittsburgh to 65% in Milwaukee.
The average bill for gall bladder removal in the seven markets – factoring in 41% outpatient and 59% inpatient procedures – was $38,215 per surgery. The MAP® Program's goal is target billed charges selection for such procedures is $14,535 – already within range of the fees charged for outpatient gall bladder removal in New York City, Pittsburgh, and Cedar Rapids. But with hospitals in those markets charging well more than double that amount for inpatient procedures and still reporting relatively high complication rates, it becomes easier to question the validity of recommending inpatient versus outpatient surgery for a gall bladder removal. In the aggregate, patients don't achieve better outcomes by having their surgeries performed in the hospital, and the expenses are much, much higher.
The best time to contact MAP® is immediately after your employees learn that they need a surgical procedure and before they schedule one.
A MAP® Nurse Advocates will answer all of your employees' questions about providers, facilities, and costs confidentially and objectively, and provide them with factual information about a prospective surgeon's credentials, rates of complication, and malpractice and disciplinary history.
MAP® is a completely independent provider not affiliated with insurance companies.
For more information on this data and other revealing healthcare statistics please call us at 1.888.289.0700.