Consumers can make informed decisions when choosing a Vermont hospital by using Hospital Report Cards. Hospital Report Cards can be used to review and compare information about community and psychiatric hospitals in these categories:
- Quality of care (outcomes, patient satisfaction and more)
- Costs for common services
- Healthcare-associated infection ratios
- Nurse staffing levels
- Patient safety
- Hospitals’ financial information
Consumers can find information on each hospital’s website to help them make decisions, including what financial assistance a hospital offers. Hospitals are required to make the following information available on their websites:
- Discount and free care policies for financial assistance
- Community health needs assessment (CHNA) reports
- CHNA Implementation plans
- Annual progress reports of CHNA Implementation plan
- Hospital governance descriptions
- Hospital complaint process
Information for consumers
* Information is updated quarterly. Current dates of data collection.
Charges are the list price set by the hospital before any discounts, write-offs, insurance adjustments, etc. are applied.
Charges by hospital are the charges of the top 20 inpatient diagnoses and outpatient procedures.
Counts by hospital are the counts of the top 20 inpatient diagnoses and outpatient procedures.
Charges by hospital
Counts by hospital
Pricing by service type
- Physician Services (Office Visits, Specialist Consultations, and Preventive Medicine Services)
- Laboratory Services (Blood Tests, Fecal Tests, Urine Tests, and Swab Tests)
- Cardiology Services
- Emergency Services
- Radiology Services (CT Scans)
- Radiology Services (MRIs)
- Radiology Services (X-Rays)
- Radiology Services (Mammograms)
- Obstetric/Gynecological Procedures
- Diagnostic Procedures (Colonoscopies)
- Integrative Medicine
- Health and Behavior Assessment/Intervention
- Psychiatry (Psychiatric Diagnostic Procedures)
- Physical Medicine and Rehabilitation
- Radiology Services (Ultrasounds, Other Imaging Procedures)
- Other services
Why does Vermont report charges for hospital and physician services?
Hospitals are required to report charges for “high volume health care services” according to Vermont law (18 V.S.A. § 9405b) With “…valid, reliable, useful, and efficient information,” patients can make informed decisions about their healthcare.
What services are included in the charge lists?
There are three different lists: hospital charges for inpatient stays (DRG codes), hospital charges for outpatient procedures (CCS - Services and Procedures), and hospital and physician charges for common outpatient services (CPT codes). For inpatient stays and outpatient procedures, the list shows hospital charges for higher volume procedures they performed. For common outpatient services, the list is from a selection of charges developed by reviewing other states’ websites, employer claims data, and data from Vermont hospitals. Hospital and physician charges are shown for this list where applicable.
Why do charges for certain procedures vary across hospitals?
Charges could vary because of the unique circumstances related to each patient’s illness. Also, hospitals have a unique mix of patients served, as well as different types and quantities of services they provide. All of these factors affect the charge for a service.
Is the amount that’s listed for a procedure the actual amount that I will be charged and have to pay?
The amounts that are listed for hospital inpatient stays (DRGs) and hospital outpatient services and procedures (CCS) are the average full charge for a procedure. However, very few people actually pay full charges. The actual amount paid will depend upon many variables, including an individual’s insurance plan and the complexity of his/her procedure. The amounts that are listed for common outpatient services (CPT) are the actual price for that service as listed in the hospital chargemaster as of October 1 (some prices are established on January 1).
What is the chargemaster?
The chargemaster is a comprehensive and hospital-specific listing of each item and service that can be billed to a patient, insurance company, or other payer. Every item and service has a specific code and corresponding charge in the charge master. Since there are usually multiple healthcare services provided to a patient, the total invoice typically includes a list of multiple services for a given visit or admission. A patient’s bill is the sum total of this array of services. For example, selected medical events for a given patient may have one code or several codes included in the final invoice for patient care.
What if I have insurance? How does that affect the charge, and how much will I have to pay?
What you will pay depends upon your insurance plan. If you are insured, you will pay only the co-payment, co-insurance, and/or deductible required by your plan, regardless of the total gross charge. Your insurance company will pay a negotiated amount to the hospital that represents some portion of the charge – generally less than the full charge. In some cases, a negotiated discount may be applied to your deductible.
What do I have to pay if I don’t have insurance?
Some hospitals have discount policies for patients who have no insurance, under which the patient receives a discount off of the full charge, similar to the discounts negotiated by insurance companies. All hospitals have free care policies for low-income patients. You can call a hospital to learn about its policies and application process. Financial counselors are available at the hospitals to help answer specific questions and guide you through the process.
Are physician charges included in the prices shown?
Physician charges are included in the list of common CPT outpatient services where applicable. However, the amounts shown for inpatient stays and outpatient procedures do NOT include physician charges. Those charges only include hospital charges.
How do I find information on charges for procedures that are not listed in this report?
If you want to find charges on procedures that are not listed, call the hospital directly and talk to their consumer services representative or someone in the billing department. In nearly all cases, the hospital can provide an estimated charge, but will not be able to give you an absolute price. Individual circumstances can affect the final charges for care.
Should I make a decision based on the charges listed or are there other factors I should consider?
The gross charge is simply one factor in deciding where to go for healthcare. Other factors that should be considered are the location of your doctor, the services offered by a particular hospital, how many of the procedures the hospital has performed, the quality reporting by a hospital, waiting times for the procedure, etc. You also may want to ask questions of your healthcare provider for a better understanding of options for your personal situation.
Where does the pricing information come from for these different hospital services?
The source of the inpatient (DRG) and outpatient (CCS - Services and Procedures) pricing information is the Vermont Uniform Hospital Discharge Data Set. Billing information is compiled into a database and the charges are taken from the database under a set of agreed upon standards. Hospital and physician pricing for outpatient diagnostic services are based upon Common Procedural Terminology (CPT®) code charges that are contained in each hospital’s chargemaster. The hospitals provide these prices directly to the Vermont Department of Health.
All Vermont hospitals provide financial assistance for emergency and medically necessary care to people who are unable to pay. Link to hospitals' discount and free care policy and financial assistance programs.
Healthcare-associated Infections (HAI) are infections that people can get while receiving services at a healthcare facility. Bacteria, viruses and fungi can be passed from patient, healthcare provider to surfaces and back. Hospitals can reduce the risk of HAIs by taking steps developed by the Centers for Disease Control and Prevention and the Institute for Healthcare Improvement.
When using these reports, it helps to understand the Standardized Infection Ratio. SIR is a statistic used to track healthcare-associated infection prevention progress over time. The SIR for a facility or state is adjusted to account for factors that might cause infection rates to be higher or lower, such as hospital size, the type of patients a hospital serves, surgery types and patient characteristics.
Some known healthcare-associated infections are:
Central Line-Associated Bloodstream Infection (CLABSI) - a serious infection that occurs when germs (usually bacteria or viruses) enter the bloodstream through the central line. CLABSIs result in thousands of deaths each year and billions of dollars in added costs to the U.S. healthcare system, yet these infections are preventable.
Clostridium difficile (C. Diff) - a bacterium that causes diarrhea and colitis (an inflammation of the colon). C. Diff causes almost half a million illnesses in the United States each year.
Vermont hospital ratings for CLABSI and C. Diff can be found in the Hospital Report Card.
Surgical Site Infections (SSI) - an infection that occurs after surgery in the part of the body where the surgery took place. It can be a superficial infection or more serious and can involve tissues under the skin, organs, or implanted material.
Vermont hospital surgical site infection (SSI) rates for three common surgeries:
Adequate nurse staffing has shown to help achieve improvements in patient care including:
- Patient satisfaction and health-related quality of life
- Decrease in:
- medical and medication errors.
- number of preventable events such as patient falls, pressure ulcers, healthcare-associated infections (HAIs) and other complications related to hospitalizations.
- patient mortality, hospital readmissions and length of stay.
- patient care costs through avoidance of unplanned readmissions.
- nurse fatigue, thus promoting nursing safety, nurse retention and job satisfaction, which all contribute to safer patient care.
Nurse staffing is measured by nursing care hours per patient day (the number of nursing care hours relative to the patient workload). This measure was developed by the American Nurses Association for the National Database of Nursing Quality Indicators.
There is no national standard for optimal nurse staffing level. This is due to varying factors like intensity of patient's needs, the number of admissions, discharges and transfers during a shift, level of experience of nursing staff, layout of the unit and availability of resources (ancillary staff, technology etc.). Patients can get a sense of staffing levels at Vermont hospitals by reading the reports in this section.
What are “nursing care hours”?
Nursing Care Hours Per Patient Day refers to the number of hours of nursing care provided on a hospital unit, compared to the number of patients on that unit during a 24-hour period. This measure was developed by the American Nurses Association for the National Database of Nursing Quality Indicators. “Nursing care hours” are the number of hours worked by nursing staff that have direct patient care responsibilities for more than 50% of their shift.
- RN nursing care hours include hours worked by registered nurses (RNs).
- Total nursing care hours include hours worked by registered nurses (RNs), licensed practical and vocational nurses, licensed nurse’s aides, and mental health technicians.
What are “patient days”?
“Patient days” are the daily average of the number of patients on the unit, as counted at least once during each shift for 24 hours.
Should the results of this measure be compared among hospitals?
There are some very important reasons why hospitals should not be compared to each other for this measure, including:
- There are no published national averages or standards with which to compare the Vermont results.
- The measure does not account for hospital differences in physical layout, frequency of admissions and discharges, or other factors that might impact nurse staffing needs.
- The results are not adjusted to account for factors that might require more nursing care hours (e.g., age of patients, severity of patient illnesses).
Brattleboro Memorial Hospital - Medical/Surgical (2nd Floor) Unit, Progressive Care Unit, Birthing Center
Central Vermont Medical Center - Medical/Surgical Unit, Women and Children’s Unit, Intensive Care Unit, Psychiatric Unit
Copley Hospital - Acute Care Nursing Unit, Birthing Center
The University of Vermont Medical Center - Intensive Care Unit, Inpatient Psychiatric Unit, Inpatient Rehabilitation Unit, Medical/Surgical Unit, Mother-Baby Unit, Pediatrics Unit, Neonatal Intensive Care Unit
Gifford Medical Center - Medical/Surgical Unit, Birthing Center
Grace Cottage Hospital - Medical/Surgical Unit
Mt. Ascutney Hospital - Medical/Surgical Unit
North Country Hospital - Medical/Surgical Unit, Intensive Care Unit
Northeastern Vermont Regional Hospital - Intensive Care Unit, Birthing Center, Medical/Surgical Unit
Northwestern Medical Center - Intensive Care Unit, Medical/Surgical Unit, Progressive Carre Unit (temporary), Progressive Care Unit West (temporary), Progressive Care Unit Combined
Porter Medical Center -Medical/Surgical Combined Unit
Rutland Regional Medical Center - Medical/Surgical Unit (5th floor), Progressive Care Unit, Surgical Care Unit, Intensive Care Unit, Psychiatric Inpatient Services and Intensive Care Unit, Women & Children's Unit
Southwestern Vermont Medical Center - Intensive Care Unit, Medical/Surgical Unit
Springfield Hospital - Inpatient Care Unit, Psychiatric Unit (Windham Center)
Vermont hospitals must report Serious Reportable Events (SREs) that occur in the hospital, such as falls with injury, pressure ulcers and events related to surgery. The Vermont’s Patient Safety Surveillance and Improvement System (VPSSIS) collects mandatory reports from hospitals to improve patient safety, eliminate adverse events and support quality improvement efforts by Vermont hospitals.
HOSPITAL FINANCIAL INFORMATION
These documents show the financial health of the different hospitals as required by Vermont statute.
- Financial Data for Actual 2017, Actual 2018 and Budget 2019
- Cost Shift for Budget 2017 and Actual 2018
- Financial Indicators for Actual 2017, Actual 2018, Budget 2019
- Capital Indicators for Actual 2017, Actual 2018, Budget 2019
- Capital Investments Budget 2019 and Plans 2020-2022
- Trend (Report 7)
- System Trends
Vermont hospitals share information for consumers including community health needs assessments, strategic plans, annual progress reports, hospital governance, discount and free care policies and their complaint processes. Psychiatric hospitals share quality improvements made instead of the needs assessment. Find this information on hospital pages through the links below.
A summary of Vermont hospitals' priority health needs is found here.
Other healthcare comparision sites:
- Hospital Compare has information about the quality of care at over 4,000 Medicare-certified hospitals across the country.
- The Leap Frog Group is a national nonprofit organization driving a movement for giant leaps forward in the quality and safety of American healthcare.
- Agency for Healthcare Research and Quality lists quality indicators and their resources.
- Other states’ healthcare websites generated using MONAHRQ.
- A Guide to Choosing a Hospital by Medicare.gov.
- Quality Check helps you find organizations that have achieved the Gold Seal of Approval from The Joint Commission.
- Medicaid Score Card explores key characteristics of Medicaid and CHIP in Vermont.
- 2019 Hospital Report Card Reporting Manual for Community Hospitals
- 2019 Hospital Report Card Reporting Manual for Psychiatric Hospitals
- Nurse Staffing Data Collection Template: FTE based (for April 2019-March 2020)
- Nurse Staffing Data Collection Template: Hour based (for April 2019-March 2020)
- Financial Reporting Template for Vermont Psychiatric Care Hospital
- Financial Reporting Template for Brattleboro Retreat