Medicare enrollees pay more at critical access hospitals: 5 things to know

A recent Wall Street Journal analysis found Medicare patients pay more out-of-pocket costs at critical access hospitals than other larger institutions, according to Fierce Health Finance.

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Here are five things to know:

1. The analysis found a Medicare patient had to pay an average co-pay of $840.22 for a colonoscopy at a critical access hospital in 2013. At a general hospital, the same procedure cost $270.53.

2. Similar gaps for procedures, such as bunion removals and hernia surgeries, were found in the analysis.

3. The cost differences are due to a 1997 general legislation that developed the critical access designation, allowing such facilities to be paid more to perform services. Therefore, Medical enrollees are forced to pay a 20 percent co-pay of that higher payment.

4. Medicare patients paid almost half of the total $3.2 billion that Medicare spent on outpatient care at critical access hospitals in 2012.

5. Medicare patients who received outpatient serves at general hospitals paid less than 25 percent of the $3.2 billion in 2012.

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