Analyzing negotiated prices between hospitals in Kansas City and United Healthcare reveals incredible differences in hospital prices that different hospitals charge for the same services. 

While these represent averages across MS-DRG and CPT codes analyzed, a single example is revealing. Below are the negotiated prices for a single live birth without complications (MS-DRG 807 ‘Vaginal delivery without sterilization or d&c without CC/MCC’):

•  Hospital 7: $4,943
• Hospital 11: $5,562
•  Hospital 8: $7,071
• Hospital 5: $10,187
• Hospital 17: $11,659
• Hospital 13: $13,668

These differences highlight the opportunity available for employers in Kansas City. If any of the lower-cost hospitals are high-quality, employers in Kansas City could share the savings with their team members who choose one of these high-quality and affordable options for care. 

Do nurses at different KC hospitals feel their hospital is safe? When asked if they would have confidence in the safety of care in their hospital if it were their loved one receiving care, 35.6% of nurses did not report confidence in the safety in their hospital. 

The actual interviews between nurses are extremely revealing:

Representative Insight From Nurse at Hospital 8: “I would absolutely recommend this hospital to anyone inquiring about the quality of care. Just recently, I had a family member who was admitted as an inpatient, and I must say, she received exceptional care.”

Representative Comment From Nurse at Hospital 9: “If I were asked about the care at [Hospital 9], I would want to know what they are looking to go to the hospital for. I think that [Hospital 9] is one of the better ones. There are issues with all hospitals in my opinion. If it were something life threatening, they should of course go. I think that [Hospital 9] is good at the ER/ICU. They can improve in other areas of the hospital. I think really it is nursing floors that are stretched pretty thin.”

Representative Comment From Nurse at Hospital 12: “Our care is very poor. If my family member needed trauma services, I would say that we are a Level 1 trauma center and we have a lot of experience with that. It’s sad that we have a group of very intelligent and hardworking nurses who entered nursing for all the right reasons, but they are put in positions that compromise their integrity. It didn’t used to be like this. This hospital used to be the place to work, and I used to be proud to work here.” 

 Putting this cost and quality analysis together reveals an overall negative correlation between cost and quality in the United Health Choice Plus network, meaning that on average, employers and patients are paying more when they receive lower-quality care!

Hospitals fall into four quadrants:

High Cost, High Quality: These EXPENSIVE BUT WORTH IT hospitals deliver excellent care but at rates that are difficult for employers to sustain. In many cities, this will be the health system with an excellent reputation and multiple hospitals. With a larger network, these health systems are able to negotiate a higher price with insurance networks. 

Low Cost, Low Quality: These GET WHAT YOU PAY FOR hospitals are often struggling. In many cities, these hospitals are not part of a larger network and will have almost no reputation/brand. 

High Cost, Low Quality: These EXPENSIVE AND DANGEROUS hospitals often are part of a network, allowing them to demand higher prices from insurance networks, and have excellent marketing promoting their brand. However, the actual care in these hospitals is lacking, with caregivers often asked to cut corners. 

Low Cost, High Quality: These AFFORDABLE VALUE hospitals are key to employer cost savings and employee high-quality care. Often, these are hospitals that are not part of a large network, limiting their ability to charge higher prices, however, they have shown a dedication to high quality care.