Chicago!

Chicago!

Analysis of Chicago Hospitals for Variations in Hospital Billing and Medicare Payments

Ankit Agrawal and Alok Choudhary
Northwestern University
{ankitag,choudhar}@eecs.northwestern.edu

This work is a sequel to our earlier study published as a paper at KDD DMH 2013. Our goal here is to study the variation in the charges of and payments to 27 hospitals in Chicago. We rank 100 health conditions (DRGs) and 27 Chicago hospitals in different ways to discover interesting insights.

We present below heat maps of data for Chicago Hospitals to make a visual analysis of hospital charges for different conditions. The first map depicts the charges of various Chicago hospitals for different medical conditions. The second presents the Medicare payments made to the hospitals for those conditions while the last shows normalized hospital charges (normalization procedure defined in our paper). Red cells are on the highest end (relatively the most expensive) compared to the US average while blue cells are on the lowest (relatively the cheapest). Yellow cells are on par with the US average. White cells imply that our dataset did not have the corresponding hospital-condition data.


Chicago Hospital Heat Maps

Hospital Billing

Medicare Payments

Normalized Hospital Billing


We made the following overarching observations about Chicago.

Is Chicago the alcohol/drug abuse and psychoses treatment capital of the US?

There may be several reasons for these observations although the CMS data itself is insufficient to draw conclusions.

Selected interesting hospital-related facts:

The list of all 27 hospitals sorted in descending order of their relative cost with respect to US averages is shown below (click on the header to sort by a different column):

HospitalDRG CoverageAvg (Cost / USavg)Avg (Payment / USavg)Avg (NormCost / USavg)Correl (Cost, Pay)
The University of Chicago Medical Center771.691.581.080.40
Swedish Covenant Hospital881.441.191.230.35
Northwestern Memorial Hospital991.321.311.000.69
St Mary & Elizabeth Med Ctr-Division Campus821.271.300.980.41
Advocate Illinois Masonic Medical Center771.221.430.860.47
Jackson Park Hospital391.211.240.970.53
Rush University Medical Center871.191.470.810.45
Roseland Community Hospital281.181.180.990.42
University of Illinois Hospital621.141.820.620.57
Resurrection Medical Center931.131.001.140.42
Saint Anthony Hospital301.091.230.890.43
Our Lady of the Resurrection Med Ctr671.080.961.140.51
Saint Joseph Hospital711.031.200.860.45
Mt Sinai Hospital Medical Center631.001.450.690.61
Louis A Weiss Memorial Hospital720.991.160.850.49
Norwegian-American Hospital290.951.290.730.58
South Shore Hospital400.931.080.860.73
Advocate Trinity Hospital650.891.060.840.37
Holy Cross Hospital670.871.000.860.59
Sacred Heart Hospital220.821.260.650.55
Methodist Hospital of Chicago240.701.120.620.65
St Bernard Hospital320.691.260.540.64
Mercy Hospital and Medical Center820.641.270.510.61
Thorek Memorial Hospital340.641.120.570.65
John H Stroger Jr Hospital420.511.600.320.68
Loretto Hospital230.491.180.420.39
Provident Hospital of Chicago100.331.180.280.45

Below is the list of all 100 DRGs sorted in descending order of the variation in their cost within Chicago (click on the header to sort by a different column):

DRG Definition#Hospitals%USdischarges%USavgCost%USavgPay%USavgNormCostVariationInCost (Stddev/Avg)Correlation (Cost, Pay)
897 - Alcohol/Drug Abuse or Dependence w/o Rehabilitation Therapy w/o Mcc176.97%50.21%110.23%35.47%0.630.22
698 - Other Kidney & Urinary Tract Diagnoses w Mcc121.74%115.21%120.22%93.07%0.600.80
811 - Red Blood Cell Disorders w Mcc151.57%108.81%124.59%84.86%0.470.66
207 - Respiratory System Diagnosis w Ventilator Support 96+ Hours161.16%90.90%111.01%80.83%0.440.49
282 - Acute Myocardial Infarction, Discharged Alive w/o Cc/Mcc70.47%119.69%133.21%87.15%0.430.30
870 - Septicemia or Severe Sepsis w Mv 96+ Hours131.54%89.11%103.08%83.09%0.430.70
853 - Infectious & Parasitic Diseases w O.R. Procedure w Mcc141.15%97.29%105.42%92.59%0.420.78
885 - Psychoses115.84%72.93%109.27%60.40%0.400.66
203 - Bronchitis & Asthma w/o Cc/Mcc141.71%94.27%124.87%73.00%0.400.07
682 - Renal Failure w Mcc221.02%108.57%128.29%83.87%0.390.42
291 - Heart Failure & Shock w Mcc250.87%108.84%122.69%93.32%0.380.40
202 - Bronchitis & Asthma w Cc/Mcc151.02%118.79%141.79%83.52%0.380.39
640 - Misc Disorders of Nutrition,Metabolism,Fluids/Electrolytes w Mcc221.44%110.54%124.12%86.31%0.380.18
208 - Respiratory System Diagnosis w Ventilator Support <96 Hours210.83%103.57%123.78%82.76%0.380.19
249 - Perc Cardiovasc Proc w Non-Drug-Eluting Stent w/o Mcc90.49%124.16%142.23%80.77%0.37-0.37
074 - Cranial & Peripheral Nerve Disorders w/o Mcc131.56%102.77%135.40%73.51%0.370.68
314 - Other Circulatory System Diagnoses w Mcc201.37%112.94%127.78%86.02%0.360.34
391 - Esophagitis, Gastroent & Misc Digest Disorders w Mcc181.17%109.59%129.82%81.24%0.360.52
190 - Chronic Obstructive Pulmonary Disease w Mcc260.77%111.73%125.63%92.16%0.360.21
305 - Hypertension w/o Mcc201.92%95.39%122.49%74.90%0.360.04
394 - Other Digestive System Diagnoses w Cc181.05%106.96%127.53%80.49%0.350.34
482 - Hip & Femur Procedures Except Major Joint w/o Cc/Mcc60.60%115.11%116.44%97.84%0.350.40
812 - Red Blood Cell Disorders w/o Mcc261.49%107.58%133.34%81.67%0.340.38
189 - Pulmonary Edema & Respiratory Failure110.25%134.56%125.29%100.71%0.340.48
292 - Heart Failure & Shock w Cc271.01%112.46%132.09%88.68%0.340.17
243 - Permanent Cardiac Pacemaker Implant w Cc80.47%110.92%128.26%85.16%0.340.43
603 - Cellulitis w/o Mcc261.01%95.39%126.29%78.75%0.340.51
057 - Degenerative Nervous System Disorders w/o Mcc151.19%97.01%118.25%79.06%0.330.58
392 - Esophagitis, Gastroent & Misc Digest Disorders w/o Mcc270.96%101.62%131.60%80.32%0.330.27
378 - G.I. Hemorrhage w Cc210.73%121.45%127.08%96.38%0.330.18
948 - Signs & Symptoms w/o Mcc221.37%108.85%126.56%83.64%0.330.23
390 - G.I. Obstruction w/o Cc/Mcc110.73%122.35%131.65%91.92%0.330.79
313 - Chest Pain261.28%100.84%122.30%78.66%0.320.07
684 - Renal Failure w/o Cc/Mcc80.66%117.97%125.66%90.54%0.320.62
312 - Syncope & Collapse271.24%95.71%121.28%77.93%0.320.07
638 - Diabetes w Cc241.45%101.35%120.39%81.58%0.32-0.10
329 - Major Small & Large Bowel Procedures w Mcc110.75%121.70%131.71%91.79%0.320.77
918 - Poisoning & Toxic Effects Of Drugs w/o Mcc110.79%109.64%124.48%85.24%0.320.05
871 - Septicemia or Severe Sepsis w/o Mv 96+ Hours w Mcc250.82%112.37%115.18%102.12%0.310.37
439 - Disorders of Pancreas Except Malignancy w Cc70.72%111.08%138.80%76.01%0.310.62
293 - Heart Failure & Shock w/o Cc/Mcc261.16%106.04%131.66%81.36%0.310.14
192 - Chronic Obstructive Pulmonary Disease w/o Cc/Mcc271.00%102.23%127.93%81.32%0.310.02
065 - Intracranial Hemorrhage or Cerebral Infarction w Cc180.75%118.90%127.87%95.23%0.310.34
286 - Circulatory Disorders Except Ami, w Card Cath w Mcc111.12%125.82%129.94%95.16%0.310.68
064 - Intracranial Hemorrhage or Cerebral Infarction w Mcc150.83%123.39%125.49%99.07%0.310.66
310 - Cardiac Arrhythmia & Conduction Disorders w/o Cc/Mcc220.70%115.75%132.00%87.90%0.310.09
917 - Poisoning & Toxic Effects of Drugs w Mcc30.21%57.42%115.95%48.00%0.31-0.08
149 - Dysequilibrium161.53%95.59%116.54%78.10%0.30-0.47
101 - Seizures w/o Mcc251.63%96.26%119.94%77.60%0.300.31
246 - Perc Cardiovasc Proc w Drug-Eluting Stent w Mcc Or 4+ Vessels/Stents60.51%153.32%134.18%109.05%0.300.71
330 - Major Small & Large Bowel Procedures w Cc130.80%130.93%134.86%93.87%0.300.15
377 - G.I. Hemorrhage w Mcc160.96%110.98%121.12%89.75%0.300.43
699 - Other Kidney & Urinary Tract Diagnoses w Cc121.75%109.79%120.28%87.49%0.300.21
177 - Respiratory Infections & Inflammations w Mcc110.54%111.90%117.84%96.92%0.300.36
069 - Transient Ischemia210.89%103.29%127.43%82.27%0.290.12
683 - Renal Failure w Cc210.81%100.98%126.23%80.54%0.29-0.05
066 - Intracranial Hemorrhage Or Cerebral Infarction w/o Cc/Mcc140.71%122.66%137.55%88.14%0.290.19
191 - Chronic Obstructive Pulmonary Disease w Cc260.86%106.64%124.63%88.36%0.290.03
193 - Simple Pneumonia & Pleurisy w Mcc200.53%118.64%125.92%95.13%0.290.23
552 - Medical Back Problems w/o Mcc191.03%99.76%129.59%76.05%0.290.28
280 - Acute Myocardial Infarction, Discharged Alive w Mcc160.77%116.95%115.67%100.71%0.280.60
247 - Perc Cardiovasc Proc w Drug-Eluting Stent w/o Mcc120.47%141.88%141.48%91.52%0.280.68
300 - Peripheral Vascular Disorders w Cc191.40%103.30%131.10%77.62%0.280.19
308 - Cardiac Arrhythmia & Conduction Disorders w Mcc150.76%114.78%120.02%93.59%0.280.57
287 - Circulatory Disorders Except Ami, w Card Cath w/o Mcc170.74%131.11%134.59%92.56%0.28-0.08
389 - G.I. Obstruction w Cc130.73%115.59%122.12%93.40%0.280.34
690 - Kidney & Urinary Tract Infections w/o Mcc260.88%109.62%129.48%90.18%0.270.11
641 - Misc Disorders of Nutrition,Metabolism,Fluids/Electrolytes w/o Mcc261.17%110.24%131.14%87.20%0.270.19
602 - Cellulitis w Mcc101.17%94.05%117.06%79.26%0.270.04
315 - Other Circulatory System Diagnoses w Cc71.05%130.71%144.91%87.34%0.270.62
301 - Peripheral Vascular Disorders w/o Cc/Mcc121.46%109.28%135.59%78.89%0.26-0.20
176 - Pulmonary Embolism w/o Mcc130.84%104.84%135.08%74.94%0.26-0.13
480 - Hip & Femur Procedures Except Major Joint w Mcc50.44%114.94%115.67%98.99%0.250.84
194 - Simple Pneumonia & Pleurisy w Cc250.62%116.20%127.38%93.13%0.25-0.27
195 - Simple Pneumonia & Pleurisy w/o Cc/Mcc230.68%104.29%131.60%79.58%0.25-0.12
303 - Atherosclerosis w/o Mcc100.63%123.26%123.62%96.89%0.250.53
491 - Back & Neck Proc Exc Spinal Fusion w/o Cc/Mcc60.59%140.76%140.24%93.83%0.240.06
481 - Hip & Femur Procedures Except Major Joint w Cc120.46%123.20%126.57%95.29%0.230.62
178 - Respiratory Infections & Inflammations w Cc110.58%120.09%121.24%100.40%0.230.40
253 - Other Vascular Procedures w Cc140.87%120.31%130.19%87.86%0.230.74
379 - G.I. Hemorrhage w/o Cc/Mcc151.09%101.48%123.85%81.55%0.23-0.19
372 - Major Gastrointestinal Disorders & Peritoneal Infections w Cc100.83%96.70%125.91%76.23%0.230.26
281 - Acute Myocardial Infarction, Discharged Alive w Cc130.60%129.18%124.76%99.71%0.220.21
419 - Laparoscopic Cholecystectomy w/o C.D.E. w/o Cc/Mcc40.51%113.90%142.85%77.96%0.220.41
689 - Kidney & Urinary Tract Infections w Mcc180.92%107.08%122.31%87.78%0.210.25
309 - Cardiac Arrhythmia & Conduction Disorders w Cc180.79%114.98%126.68%89.53%0.210.23
252 - Other Vascular Procedures w Mcc141.17%118.13%122.72%93.68%0.21-0.01
536 - Fractures Of Hip & Pelvis w/o Mcc40.38%105.02%113.10%93.16%0.210.71
473 - Cervical Spinal Fusion w/o Cc/Mcc40.46%130.55%134.87%94.43%0.210.09
872 - Septicemia or Severe Sepsis w/o Mv 96+ Hours w/o Mcc150.58%120.04%118.27%102.18%0.200.24
470 - Major Joint Replacement or Reattachment of Lower Extremity w/o Mcc160.62%115.87%131.63%84.64%0.190.60
039 - Extracranial Procedures w/o Cc/Mcc40.32%153.58%126.48%113.95%0.190.99
469 - Major Joint Replacement or Reattachment of Lower Extremity w Mcc50.51%116.20%124.29%90.71%0.170.84
238 - Major Cardiovasc Procedures w/o Mcc60.62%121.45%124.76%92.98%0.170.68
244 - Permanent Cardiac Pacemaker Implant w/o Cc/Mcc40.24%131.11%117.90%107.23%0.170.96
563 - Fx, Sprn, Strn & Disl Except Femur, Hip, Pelvis & Thigh w/o Mcc70.72%107.55%112.14%92.19%0.160.79
251 - Perc Cardiovasc Proc w/o Coronary Artery Stent w/o Mcc60.51%143.95%132.22%107.33%0.140.15
254 - Other Vascular Procedures w/o Cc/Mcc80.52%115.32%118.55%90.89%0.13-0.11
460 - Spinal Fusion Except Cervical w/o Mcc80.63%122.47%136.35%87.96%0.12-0.05
418 - Laparoscopic Cholecystectomy w/o C.D.E. w Cc50.42%131.63%132.86%98.26%0.090.57