Hospital ownership changes and charge-to-cost shifts

Abstract

We examine hospital-level CCR – charges to Medicare-allowable costs – from 2011 to 2022 among governmental, for-profit, and non-profit hospitals and identify hospitals that charged extreme CCR of over 1000% of the cost. We tracked hospitals that experienced ownership transitions and found that governmental and non-profit hospitals’ average CCR increased by 161% and 99.7%, respectively, after transitioning to become for-profits. These higher CCRs affect uninsured patients, out-of-network patients, and casualty and workers’ compensation insurers.