DFW’s Most Expensive Hospitals

HCA Healthcare is the region’s most expensive hospital system, though others are not far behind, according to a 2019 Rand Corporation study and interactive map that measured prices paid at hospitals relative to the Medicare reimbursement rate. The HCA system, which includes hospitals in several states and is the parent company of Medical City Healthcare, received 303 percent of what Medicare reimburses for the same procedures and facilities, according the study.

The study did not include every hospital in the region, conspicuously leaving out UT Southwestern and Parkland, but was compiled with data from self-insured employers, state-based all-payer claims databases, and health plans to measure $13 billion in hospital spending between 2015 and 2017 in 25 states. The prices represent the negotiated amount paid per service, including what the patients and health plan pay and adjusted for the level of services provided. The prices were compared to what Medicare pays for the same procedures and facilities to determine the relative price.

Baylor Scott and White was the least expensive system recorded in the study, which was paid at 255 percent of Medicare. The Texas Health System was just behind Medical City at 294 percent. The statewide average was 244 percent, and the nationwide rate ticked up from 236 percent of Medicare rates in 2015 to 241 percent in 2017. Outpatient care in hospitals was measured at 293 percent of Medicare rates, outpacing 203 percent for inpatient care. The higher outpatient hospital costs have led to the proliferation of urgent care centers as well as advocacy toward finding facilities other than hospitals to have outpatient procedures done.

Texas was on the high side when it came to statewide reimbursement, though it was well below Wyoming, the highest state measured at 302 percent of Medicare on average. Nationwide, individual hospitals ranged from 150 percent of Medicare to over 400 percent.

Individual hospitals found on RAND’s interactive map in the region ranged from 172 percent of Medicare (Dallas Medical Center) to 400 percent (Medical Center of Plano). Baylor University Medical Center was measured at 254 percent, Methodist Dallas was 251 percent, Medical City Dallas was at 262 percent, and Texas Health Presbyterian was at 231 percent.

It will be no surprise that on average, hospitals in big cities were more affordable than suburban hospitals, with the Plano facilities ending up with several of the highest prices. That said, only a fraction of the region’s acute care hospitals were included in the study. Only one of the Methodist facilities was included, and there were no hospitals north of Plano in DFW, meaning McKinney, Allen, and Frisco hospitals were not included. Check out the North Texas hospitals from the study below, and see the interactive map and complete study here.