Whatcom County Hospital Data Project: Unresolved Data
What we do know is there is only one major hospital in Whatcom County: St Josephs Hospital, privately operated by PeaceHealth. There is a hospital called Skagit Valley Hospital nearby approx 28.3 miles away and we wanted to compare to see how much of a price difference those nearly 30 miles makes to go to a place with a public hospital district.
St Joseph's is required by law to provide information about it's prices or "Chargemaster rates" under The Centers for Medicare & Medicaid Services’ Price Transparency Final Rule. Many other hospitals are also required to comply. In an ideal world, this would allow for comparisons between hospitals. Even if the law is being complied with that does not mean the data is in a particularly usable format -- this applies to St Joes and many other hospitals- Interoperability is a concern.
What are "Chargemaster rates"?
These are the rates hospitals are required to disclose. "To the best of its knowledge and belief, the hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date indicated."
What is Interoperability of Chargemaster rates?
The ability to compare Chargemaster rates between hospitals easily. This could include more features than required by law currently. Changes are coming, from July 2024 new editions of the data will need to be published in a particular format. Currently it appears Hospitals have only to update the data every year.
Do these prices even mean anything?
This is a valid question because everything about the rates are heavily couched in disclaimers. There is no guarantee your individual service will match whatever is given by the estimation but yet these prices are arguably important on a systems level.
Get the most recent Whatcom County Hospital Data (June 2024)
As you will see at this live link of prices, there is an option to download the full machine readable pricing. Unfortunately, this data is not optimally usable for data analysis. Other hospitals have released data of varying quality also, but we just took a look at St Josephs and one other regional hospital in a nearby county, Skagit Valley Hospital. Some similar problems were found with a comparison with Skagit Valley in terms of interoperability.
What we found so far
Our small independent research team built on inspiration from work by the Cascadia Daily News, August 2024. The most recent .CSV file has 12588 rows, 230 columns. We started with a goal of cleaning the data and presenting it in a GitHub Repository for analysis.
We ran into a few problems with the data... these may be common problems in the healthcare industry and other hospitals too but Whatcom was no exception.
1. Web Search results not always accurate with machine readable data
Prices in the public spreadsheet do not consistently match the price estimator tool they provide. Though in cases where there’s a single price, that might just be because they updated the machine readable version less frequently or something else.
2. Potentially inflated number of procedures
There are approximately 10K unique procedures listed in the CSV data. Do they offer all of them currently? It is a question of how much, as there appears to be duplicate rows for a number of procedures with the same name. Many procedures listed in the machine readable file do not appear surfaceable in the estimation tool (this could be for several reasons, but adds to some doubt).
3. Large number of duplicate rows: hard to decipher without guidance
Approximately 10% of the procedures have duplicate rows listing sometimes quite different prices for no readily discernable logic. In the St Josephs data some of these duplicates appear due to hospital location codes being different yet we are searching for a single location of the hospital so this seems a barrier.
4. PeaceHealth is not maintaining this dataset regularly*
The Machine readable file is stated at the top to last have been updated 6/25/2024. A volunteer emailed PeaceHealth about discrepancies in the data and to date we have never got a response. By a little contrast, Skagit Valley Hospital updated their dataset 9/4/2024. It appears that the data only needs to be updated by law once a year.
*- If an initial reading of 45 CFR 180.50(e) about frequency of updates is right, St Josephs should be publishing an updated format of data by late June 2025, but they could do it earlier.
The Goals
In the future we will have better quality data to actually enable meaningful pricing comparisons between other regional hospitals out of the county such as Skagit Valley Hospital.
Compare apples to apples - similar procedures to other similar procedures.
Determine whether there are any trends in the pricing, or any significant difference between private and public hospital districts.