The Queens Health Systems · Kamuela, HI
3 of 5
CMS star rating
33
Beds
1,899
Inpatient discharges a year
$109.5M
Net patient revenue a year
29
In-network payers
North Hawaii Community Hospital is a 33-bed voluntary non-profit - private hospital in Kamuela, HI, affiliated with The Queens Health Systems. Below you'll find publicly disclosed negotiated rates and facility details, including 29 in-network payers and 224 disclosed rate categories.
The 24 services North Hawaii Community Hospital most likely performs, ranked by likely volume and what it is paid. Each service names one insurer. * marks hidden insurer names; A, B and C rank the remaining rates from low to high and reset for each service.
Book a demo to see hidden insurer names, more payer rates, and hospital data, or start a free trial.
Medicine & Surgery
CPT 49505
$5,650 - $16,196
from 2 insurers · median $10,923
27 Medicare claims in Level 1 Abdominal/Peritoneal/Biliary and Related Procedures (CMS 2024)
CT imaging
CPT 74177
$1,116 - $2,655
from 3 insurers · median $1,343
Common here, based on CMS Medicare volume
Childbirth · Inpatient
MS-DRG 807
$8,805
negotiated rate
CMS lists this service as CPT 59400, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
Childbirth · Inpatient
MS-DRG 788
$16,355
negotiated rate
CMS lists this service as CPT 59510, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 788, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
Digestive procedures
CPT 45385
$4,032 - $8,850
from 2 insurers · median $6,441
Common here, based on CMS Medicare volume
Digestive procedures
CPT 49650
$8,257 - $17,328
from 2 insurers · median $12,793
19 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
Medicine & Surgery
CPT 47562
$4,032 - $10,249
from 2 insurers · median $7,140
19 Medicare claims in Level 1 Laparoscopy and Related Services (CMS 2024)
Digestive procedures
CPT 45378
$4,032 - $5,718
from 2 insurers · median $4,875
Common here, based on CMS Medicare volume
Digestive procedures
CPT 43239
$2,122 - $4,032
from 2 insurers · median $3,077
Common here, based on CMS Medicare volume
Cardiology and vascular testing
CPT 93306
$994 - $2,231
from 2 insurers · median $1,612
Common here, based on CMS Medicare volume
CT imaging
CPT 74176
$791 - $2,386
from 3 insurers · median $942
Common here, based on CMS Medicare volume
CT imaging
CPT 70450
$280 - $1,468
from 3 insurers · median $385
Common here, based on CMS Medicare volume
CT imaging
CPT 71275
$638 - $1,999
from 3 insurers · median $996
Common here, based on CMS Medicare volume
Mammography
CPT 77067
$180 - $305
from 3 insurers · median $193
Common here, based on CMS Medicare volume
MRI imaging
CPT 70553
$1,011 - $2,223
from 3 insurers · median $2,028
Common here, based on CMS Medicare volume
X-ray and bone density
CPT 71046
$51 - $294
from 2 insurers · median $172
Common here, based on CMS Medicare volume
Gynecology
CPT 58571
$3,159 - $20,249
from 3 insurers · median $9,280
Typical for a hospital with this service line
Gynecology
CPT 58558
$5,650 - $9,049
from 2 insurers · median $7,349
Typical for a hospital with this service line
Orthopedics and pain
CPT 29848
$845 - $9,250
from 3 insurers · median $5,650
33 Medicare claims in Level 2 Musculoskeletal Procedures (CMS 2024)
Gynecology
CPT 58661
$8,149 - $9,280
from 2 insurers · median $8,714
Typical for a hospital with this service line
Medicine & Surgery · Inpatient
MS-DRG 460
$68,358
negotiated rate
Hospital reports neurosurgical services to CMS
Laboratory and pathology
CPT 80053
$28 - $192
from 2 insurers · median $110
Typical for a hospital with this service line
Mammography
CPT 77066
$205 - $653
from 3 insurers · median $558
Common here, based on CMS Medicare volume
Childbirth · Inpatient
MS-DRG 807
$8,805
negotiated rate
CMS lists this service as CPT 59610, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
Median rate as a percent of Medicare across the outpatient services above, and how many services sit above or below the same insurer's median at nearby hospitals. * marks hidden insurer names. These table labels track the same insurers across services; the labels on each service card reset.
| Insurer | Services | Median % of Medicare | Above nearby | Below nearby |
|---|---|---|---|---|
| Insurer A* | 20 | 417% | 0 | 0 |
| Insurer B* | 24 | 290% | 0 | 0 |
| Insurer C* | 9 | 284% | 0 | 0 |
How we chose these services: 4 appear in this hospital's own Medicare claims, 12 are common here based on CMS Medicare volume, and 8 are typical for the service lines it reports to CMS. Rates come from insurer and hospital price transparency files as of October 2026. Rates under a quarter of Medicare or over 20 times Medicare are left out as likely physician-fee rows or file errors. Book a demo to see all 300 CMS shoppable services for North Hawaii Community Hospital, or start a free trial.
Acceptance varies by plan and service. Confirm coverage with your insurer or the hospital's billing department.
Quality
3 of 5 stars
Doctors and services
Accredited by The Joint Commission
Finances
$109.5M net patient revenue
Ownership and leadership
Owned by The Queen's Health Systems
The employer identification numbers (EINs) health plans and networks list for North Hawaii Community Hospital in the in-network rate files they publish, with the organization NPIs billed under each.
| Tax ID (EIN) | Plans and networks listing it | Organization NPIs |
|---|---|---|
| 99-0260423Queens North Hawaii Community Hospital | 40Aetna, Cigna, United Healthcare (incl Optum, Rocky Mountain, Health Plan of Nevada, Sierra Health), Aspirus Health Plan, Asuris Northwest Health and 35 more | 1477559029 Queens North Hawaii Community Hospital1780177493 Queen's North Hawaii Community Hospital1033602743 Queen's North Hawaii Community Hospitaland 7 more |
Source: PayerPrice analysis of insurers' Transparency in Coverage in-network files. An EIN can cover several hospitals and clinics in a health system, and insurers sometimes list other organizations' NPIs under it.
67-1125 Mamalahoa Highway, Kamuela, HI 96743
(808) 885-4444
How North Hawaii Community Hospital compares with other US facilities on the measures CMS publishes, mostly from Medicare patients.
Overall star rating
3 of 5
Lower than 42% of US hospitals
Combines death rates, safety, readmissions, patient experience and timely care
Death rates
No different on 4 measures
0 better, 4 no different, 0 worse than the US rate
Deaths within 30 days, such as after a heart attack, pneumonia or stroke
Safety
No different on 2 measures
0 better, 2 no different, 0 worse than the US rate
Infections, surgical complications and other harm in the hospital
Readmissions
Better on 1 of 7 measures
1 better, 6 no different, 0 worse than the US rate
Patients back in the hospital or ER soon after leaving
Patient survey rating
3 of 5
Lower than 40% of US hospitals
From the HCAHPS survey of recent inpatients
Would definitely recommend
77%
Higher than 69% of US hospitals
US median: 71%
Surveyed patients who would definitely recommend the hospital
Hospital-acquired condition penalty
Penalized
Among the worst-performing 25% of US hospitals
Medicare cuts payments 1% for the worst-performing 25% of hospitals on infections and injuries acquired in the hospital
Serious complications (PSI 90)
0.96
Lower than 51% of US hospitals
US median: 0.96
Risk-adjusted composite of complications such as bedsores, falls with hip fracture and blood clots after surgery; lower is better
Time in the ER before going home
135 min
Lower than 60% of US hospitals
US median: 148 min
Median minutes from arrival to leaving for ER patients who were sent home; lower is better
Sepsis care
82%
Higher than 88% of US hospitals
US median: 65%
Patients with severe sepsis or septic shock who got every step of the recommended early treatment; higher is better
| Measure | Result | Period |
|---|---|---|
| Overall star ratingCMS: Overall hospital quality star rating | 3 of 5 | |
| Death rates | No different on 4 measures | |
| Safety | No different on 2 measures | |
| Readmissions | Better on 1 of 7 measures | |
| Patient survey ratingCMS: Summary star rating | 3 of 5 | 2024-10-01 to 2025-09-30 |
| Would definitely recommendCMS: "YES", patients would definitely recommend the hospital | 77% | 2024-10-01 to 2025-09-30 |
| Hospital-acquired condition penaltyCMS: HAC Reduction Program payment reduction | Penalized | 2026 |
| Serious complications (PSI 90)CMS: Patient safety and adverse events composite (PSI 90) | 0.96 | 2022-07-01 to 2024-06-30 |
| Time in the ER before going homeCMS: Average (median) time patients spent in the emergency department before leaving from the visit, excluding patients transferred to another facility or psychiatric care/mental health patients. A lower number of minutes is better | 135 min | 2024-10-01 to 2025-09-30 |
| Sepsis careCMS: Appropriate care for severe sepsis and septic shock | 82% | 2024-10-01 to 2025-09-30 |
Source: CMS Provider Data Catalog, released 2026-08-13. US comparisons rank this facility among every facility CMS reports for each measure. See Medicare Care Compare.
How Medicare adjusts North Hawaii Community Hospital's inpatient payments for its readmissions, quality and cost results.
No penalty
Readmissions penalty
Hospital Readmissions Reduction Program adjustment for excess readmissions, as estimated in the FY 2027 IPPS final rule.
+1.29% on Medicare payments
Value-based purchasing
Hospital Value-Based Purchasing bonus or reduction for quality and cost, as estimated in the FY 2027 IPPS final rule.
Source: CMS IPPS final rule Impact File (FY 2027).
Each result CMS publishes for North Hawaii Community Hospital, beside the US median and the average of HI hospitals. The rank says what share of US hospitals the result is better or worse than; counts and confidence limits are not ranked.
Risk-adjusted 30-day death rates and surgical complications; lower is better.
| Measure | This hospital | US median | HI average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Rate of complications for hip/knee replacement patients2023-04-01 to 2025-03-31 | Not Available | 4.2 | |||
| Hybrid Hospital-Wide All-Cause Risk Standardized Mortality Rate2024-07-01 to 2025-06-30 · 433 cases | 3.7 | 3.9 | 3.677 | Better than 62% of US hospitals | |
| Death rate for heart attack patients2022-07-01 to 2025-06-30 | Not Available | 11.4 | |||
| Death rate for CABG surgery patients2022-07-01 to 2025-06-30 | Not Available | 1.9 | |||
| Death rate for COPD patients2022-07-01 to 2025-06-30 | Not Available | 8.983 | |||
| Death rate for heart failure patients2022-07-01 to 2025-06-30 · 46 cases | 11.5 | 11 | 10.66 | Worse than 60% of US hospitals | |
| Death rate for pneumonia patients2022-07-01 to 2025-06-30 · 71 cases | 12.6 | 15.2 | 15.07 | Better than 86% of US hospitals | |
| Death rate for stroke patients2023-07-01 to 2025-06-30 · 64 cases | 13.4 | 11.6 | 10.71 | Worse than 76% of US hospitals | |
| Pressure ulcer rate2022-07-01 to 2024-06-30 · 552 cases | 0.48 | 0.51 | 0.8555 | No Different Than the National Rate | Better than 55% of US hospitals |
| Death rate among surgical inpatients with serious treatable complications2022-07-01 to 2024-06-30 | Not Available | 174 | Number of Cases Too Small | ||
| Iatrogenic pneumothorax rate2022-07-01 to 2024-06-30 · 737 cases | 0.2 | 0.2 | 0.2464 | No Different Than the National Rate | Better than 46% of US hospitals |
| In-hospital fall-associated fracture rate2022-07-01 to 2024-06-30 · 719 cases | 0.27 | 0.27 | 0.2773 | No Different Than the National Rate | Worse than 46% of US hospitals |
| Postoperative hemorrhage or hematoma rate2022-07-01 to 2024-06-30 · 145 cases | 2.26 | 2.29 | 2.417 | No Different Than the National Rate | Better than 55% of US hospitals |
| Postoperative acute kidney injury requiring dialysis rate2022-07-01 to 2024-06-30 · 36 cases | 1.67 | 1.63 | 1.579 | No Different Than the National Rate | Worse than 72% of US hospitals |
| Postoperative respiratory failure rate2022-07-01 to 2024-06-30 · 39 cases | 8.83 | 8.88 | 8.895 | No Different Than the National Rate | Better than 51% of US hospitals |
| Perioperative pulmonary embolism or deep vein thrombosis rate2022-07-01 to 2024-06-30 · 151 cases | 4.24 | 3.4 | 3.842 | No Different Than the National Rate | Worse than 88% of US hospitals |
| Postoperative sepsis rate2022-07-01 to 2024-06-30 · 37 cases | 5.07 | 5.105 | 5.092 | No Different Than the National Rate | Better than 53% of US hospitals |
| Postoperative wound dehiscence rate2022-07-01 to 2024-06-30 · 46 cases | 1.75 | 1.72 | 1.765 | No Different Than the National Rate | Worse than 66% of US hospitals |
| Abdominopelvic accidental puncture or laceration rate2022-07-01 to 2024-06-30 · 130 cases | 1.03 | 1.02 | 1.22 | No Different Than the National Rate | Worse than 52% of US hospitals |
Unplanned returns to a hospital after a stay or an outpatient procedure; lower is better.
| Measure | This hospital | US median | HI average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Hospital return days for heart attack patients2022-07-01 to 2025-06-30 | Not Available | 9.6 | |||
| Hospital return days for heart failure patients2022-07-01 to 2025-06-30 · 45 cases | 32.7 | 1.25 | 21.92 | Worse than 85% of US hospitals | |
| Hospital return days for pneumonia patients2022-07-01 to 2025-06-30 · 66 cases | -13.3 | 3.85 | 5.255 | Better than 73% of US hospitals | |
| Hybrid Hospital-Wide All-Cause Readmission Measure (HWR)2024-07-01 to 2025-06-30 | Not Available | ||||
| Rate of unplanned hospital visits after colonoscopy (per 1,000 colonoscopies)2022-01-01 to 2024-12-31 · 256 cases | 13.4 | 12.9 | 12.99 | No Different Than the National Rate | Worse than 72% of US hospitals |
| Rate of inpatient admissions for patients receiving outpatient chemotherapy2024-01-01 to 2024-12-31 · 80 cases | 9.5 | 10.7 | 10.2 | No Different Than the National Rate | Better than 85% of US hospitals |
| Rate of emergency department (ED) visits for patients receiving outpatient chemotherapy2024-01-01 to 2024-12-31 · 80 cases | 5.7 | 5.3 | 6.222 | No Different Than the National Rate | Worse than 69% of US hospitals |
| Ratio of unplanned hospital visits after hospital outpatient surgery2024-01-01 to 2024-12-31 · 154 cases | 1.2 | 1 | 1.118 | No Different than expected | Worse than 89% of US hospitals |
| Acute Myocardial Infarction (AMI) 30-Day Readmission Rate2023-07-01 to 2025-06-30 | Not Available | 14.19 | |||
| Rate of readmission for CABG2023-07-01 to 2025-06-30 | Not Available | 10.83 | |||
| Rate of readmission for chronic obstructive pulmonary disease (COPD) patients2023-07-01 to 2025-06-30 · 32 cases | 19.6 | 19.8 | 19.52 | Better than 58% of US hospitals | |
| Heart failure (HF) 30-Day Readmission Rate2023-07-01 to 2025-06-30 · 101 cases | 22.7 | 21.3 | 21.05 | Worse than 86% of US hospitals | |
| Rate of readmission after hip/knee replacement2023-07-01 to 2025-06-30 | Not Available | 5.68 | |||
| Pneumonia (PN) 30-Day Readmission Rate2023-07-01 to 2025-06-30 · 97 cases | 17.3 | 17.2 | 16.64 | Worse than 50% of US hospitals |
Standardized infection ratios (1 is the US baseline) and the counts behind them; lower is better.
| Measure | This hospital | US median | HI average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Central Line Associated Bloodstream Infection (ICU + select Wards): Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.2329 | |||
| Central Line Associated Bloodstream Infection (ICU + select Wards): Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 2.335 | |||
| Central Line Associated Bloodstream Infection: Number of Device Days2024-10-01 to 2025-09-30 | 955 | 1,370 | 5,053 | ||
| Central Line Associated Bloodstream Infection (ICU + select Wards): Predicted Cases2024-10-01 to 2025-09-30 | 0.746 | 0.9835 | 4.482 | ||
| Central Line Associated Bloodstream Infection (ICU + select Wards): Observed Cases2024-10-01 to 2025-09-30 | 0 | 0 | 2.5 | ||
| Central Line Associated Bloodstream Infection (ICU + select Wards)2024-10-01 to 2025-09-30 | Not Available | 0.7274 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.2057 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 2.329 | |||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Number of Urinary Catheter Days2024-10-01 to 2025-09-30 | 867 | 1,799 | 4,489 | ||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Predicted Cases2024-10-01 to 2025-09-30 | 0.646 | 1.377 | 4.821 | ||
| Catheter Associated Urinary Tract Infections (ICU + select Wards): Observed Cases2024-10-01 to 2025-09-30 | 1 | 0 | 3.429 | ||
| Catheter Associated Urinary Tract Infections (ICU + select Wards)2024-10-01 to 2025-09-30 | Not Available | 0.7816 | |||
| SSI - Colon Surgery: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.3714 | |||
| SSI - Colon Surgery: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 2.964 | |||
| SSI - Colon Surgery: Number of Procedures2024-10-01 to 2025-09-30 | 16 | 61 | 84.83 | ||
| SSI - Colon Surgery: Predicted Cases2024-10-01 to 2025-09-30 | 0.351 | 1.591 | 2.192 | ||
| SSI - Colon Surgery: Observed Cases2024-10-01 to 2025-09-30 | 0 | 1 | 2.333 | ||
| SSI - Colon Surgery2024-10-01 to 2025-09-30 | Not Available | 1.054 | |||
| SSI - Abdominal Hysterectomy: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | ||||
| SSI - Abdominal Hysterectomy: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | ||||
| SSI - Abdominal Hysterectomy: Number of Procedures2024-10-01 to 2025-09-30 | 6 | 38 | 30.17 | ||
| SSI - Abdominal Hysterectomy: Predicted Cases2024-10-01 to 2025-09-30 | 0.038 | 0.328 | 0.2526 | ||
| SSI - Abdominal Hysterectomy: Observed Cases2024-10-01 to 2025-09-30 | 0 | 0 | 0.3333 | ||
| SSI - Abdominal Hysterectomy2024-10-01 to 2025-09-30 | Not Available | ||||
| MRSA Bacteremia: Lower Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 0.0446 | |||
| MRSA Bacteremia: Upper Confidence Limit2024-10-01 to 2025-09-30 | Not Available | 2.003 | |||
| MRSA Bacteremia: Patient Days2024-10-01 to 2025-09-30 | 7,651 | 14,451 | 43,478 | ||
| MRSA Bacteremia: Predicted Cases2024-10-01 to 2025-09-30 | 0.184 | 0.567 | 2.397 | ||
| MRSA Bacteremia: Observed Cases2024-10-01 to 2025-09-30 | 0 | 0 | 0.6429 | ||
| MRSA Bacteremia2024-10-01 to 2025-09-30 | Not Available | 0.2263 | |||
| Clostridium Difficile (C.Diff): Lower Confidence Limit2024-10-01 to 2025-09-30 | 0.182 | 0.127 | 0.2111 | No Different than National Benchmark | |
| Clostridium Difficile (C.Diff): Upper Confidence Limit2024-10-01 to 2025-09-30 | 3.587 | 0.747 | 1.026 | No Different than National Benchmark | |
| Clostridium Difficile (C.Diff): Patient Days2024-10-01 to 2025-09-30 | 6,965 | 13,646 | 44,003 | No Different than National Benchmark | |
| Clostridium Difficile (C.Diff): Predicted Cases2024-10-01 to 2025-09-30 | 1.842 | 5.683 | 21.87 | No Different than National Benchmark | |
| Clostridium Difficile (C.Diff): Observed Cases2024-10-01 to 2025-09-30 | 2 | 2 | 8.429 | No Different than National Benchmark | |
| Clostridium Difficile (C.Diff)2024-10-01 to 2025-09-30 | 1.086 | 0.279 | 0.4274 | No Different than National Benchmark | Worse than 95% of US hospitals |
How recent inpatients answered each survey question, with CMS's star rating per topic.
| Measure | This hospital | US median | HI average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Room was "always" clean2024-10-01 to 2025-09-30 · 370 cases | 75 | 73 | 76.47 | Better than 56% of US hospitals | |
| Room was "sometimes" or "never" clean2024-10-01 to 2025-09-30 · 370 cases | 8 | 8 | 6.733 | Better than 47% of US hospitals | |
| Room was "usually" clean2024-10-01 to 2025-09-30 · 370 cases | 17 | 18 | 16.8 | ||
| Cleanliness - linear mean score2024-10-01 to 2025-09-30 · 370 cases | 88 | 87 | 88.46 | Better than 57% of US hospitals | |
| Cleanliness - star rating2024-10-01 to 2025-09-30 · 370 cases | 4 | 4 | 3.923 | Better than 47% of US hospitals | |
| Nurses "always" communicated well2024-10-01 to 2025-09-30 · 370 cases | 80 | 80 | 79.2 | Better than 49% of US hospitals | |
| Nurse communication - linear mean score2024-10-01 to 2025-09-30 · 370 cases | 92 | 91 | 91.85 | Better than 51% of US hospitals | |
| Nurses "sometimes" or "never" communicated well2024-10-01 to 2025-09-30 · 370 cases | 4 | 4 | 4.2 | Worse than 42% of US hospitals | |
| Nurse communication - star rating2024-10-01 to 2025-09-30 · 370 cases | 4 | 3 | 3.769 | Better than 51% of US hospitals | |
| Nurses "usually" communicated well2024-10-01 to 2025-09-30 · 370 cases | 16 | 16 | 16.6 | ||
| Doctors "always" communicated well2024-10-01 to 2025-09-30 · 370 cases | 78 | 79 | 79.73 | Worse than 55% of US hospitals | |
| Doctor communication - linear mean score2024-10-01 to 2025-09-30 · 370 cases | 90 | 91 | 91.62 | Worse than 55% of US hospitals | |
| Doctors "sometimes" or "never" communicated well2024-10-01 to 2025-09-30 · 370 cases | 7 | 5 | 5.267 | Worse than 72% of US hospitals | |
| Doctor communication - star rating2024-10-01 to 2025-09-30 · 370 cases | 3 | 3 | 3.462 | Worse than 37% of US hospitals | |
| Doctors "usually" communicated well2024-10-01 to 2025-09-30 · 370 cases | 15 | 16 | 15 | ||
| Staff "always" explained2024-10-01 to 2025-09-30 · 370 cases | 59 | 61 | 61.8 | Worse than 59% of US hospitals | |
| Communication about medicines - linear mean score2024-10-01 to 2025-09-30 · 370 cases | 76 | 77 | 78.62 | Worse than 53% of US hospitals | |
| Staff "sometimes" or "never" explained2024-10-01 to 2025-09-30 · 370 cases | 20 | 19 | 17.13 | Worse than 50% of US hospitals | |
| Communication about medicines - star rating2024-10-01 to 2025-09-30 · 370 cases | 2 | 3 | 3 | Worse than 53% of US hospitals | |
| Staff "usually" explained2024-10-01 to 2025-09-30 · 370 cases | 21 | 19 | 21.07 | ||
| Discharge information - linear mean score2024-10-01 to 2025-09-30 · 370 cases | 83 | 86 | 86.46 | Worse than 74% of US hospitals | |
| No, staff "did not" give patients this information2024-10-01 to 2025-09-30 · 370 cases | 17 | 13 | 13.27 | Worse than 79% of US hospitals | |
| Discharge information - star rating2024-10-01 to 2025-09-30 · 370 cases | 3 | 3 | 3.462 | Worse than 45% of US hospitals | |
| Yes, staff "did" give patients this information2024-10-01 to 2025-09-30 · 370 cases | 83 | 87 | 86.73 | Worse than 79% of US hospitals | |
| No, staff "did not" give patients information about help after discharge2024-10-01 to 2025-09-30 · 370 cases | 18 | 14 | 14.85 | Worse than 74% of US hospitals | |
| Yes, staff "did" give patients information about help after discharge2024-10-01 to 2025-09-30 · 370 cases | 82 | 86 | 85.15 | Worse than 74% of US hospitals | |
| Doctors "always" explained things so they could understand2024-10-01 to 2025-09-30 · 370 cases | 74 | 74 | 75.38 | Better than 48% of US hospitals | |
| Doctors "sometimes" or "never" explained things so they could understand2024-10-01 to 2025-09-30 · 370 cases | 9 | 7 | 6.538 | Worse than 75% of US hospitals | |
| Doctors "usually" explained things so they could understand2024-10-01 to 2025-09-30 · 370 cases | 17 | 19 | 18.08 | ||
| Doctors "always" listened carefully2024-10-01 to 2025-09-30 · 370 cases | 77 | 77 | 78.92 | Worse than 49% of US hospitals | |
| Doctors "sometimes" or "never" listened carefully2024-10-01 to 2025-09-30 · 370 cases | 7 | 6 | 5.154 | Worse than 64% of US hospitals | |
| Doctors "usually" listened carefully2024-10-01 to 2025-09-30 · 370 cases | 16 | 17 | 15.92 | ||
| Doctors "always" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 370 cases | 82 | 85 | 85.31 | Worse than 74% of US hospitals | |
| Doctors "sometimes" or "never" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 370 cases | 5 | 3 | 3.385 | Worse than 73% of US hospitals | |
| Doctors "usually" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 370 cases | 13 | 11 | 11.31 | ||
| Patients who gave a rating of "6" or lower (low)2024-10-01 to 2025-09-30 · 370 cases | 9 | 8 | 8 | Worse than 59% of US hospitals | |
| Patients who gave a rating of "7" or "8" (medium)2024-10-01 to 2025-09-30 · 370 cases | 19 | 20 | 21.2 | ||
| Patients who gave a rating of "9" or "10" (high)2024-10-01 to 2025-09-30 · 370 cases | 72 | 72 | 70.8 | Better than 49% of US hospitals | |
| Overall hospital rating - linear mean score2024-10-01 to 2025-09-30 · 370 cases | 88 | 88 | 88.38 | Worse than 45% of US hospitals | |
| Overall hospital rating - star rating2024-10-01 to 2025-09-30 · 370 cases | 3 | 3 | 3.308 | Worse than 45% of US hospitals | |
| Staff "always" explained new medications2024-10-01 to 2025-09-30 · 370 cases | 72 | 74 | 74.46 | Worse than 62% of US hospitals | |
| Staff "sometimes" or "never" explained new medications2024-10-01 to 2025-09-30 · 370 cases | 11 | 9 | 8.615 | Worse than 62% of US hospitals | |
| Staff "usually" explained new medications2024-10-01 to 2025-09-30 · 370 cases | 17 | 16 | 16.92 | ||
| Nurses "always" explained things so they could understand2024-10-01 to 2025-09-30 · 370 cases | 76 | 75 | 75.46 | Better than 55% of US hospitals | |
| Nurses "sometimes" or "never" explained things so they could understand2024-10-01 to 2025-09-30 · 370 cases | 6 | 5 | 5.538 | Worse than 51% of US hospitals | |
| Nurses "usually" explained things so they could understand2024-10-01 to 2025-09-30 · 370 cases | 18 | 20 | 19 | ||
| Nurses "always" listened carefully2024-10-01 to 2025-09-30 · 370 cases | 79 | 77 | 76.62 | Better than 63% of US hospitals | |
| Nurses "sometimes" or "never" listened carefully2024-10-01 to 2025-09-30 · 370 cases | 4 | 4 | 4.077 | Better than 45% of US hospitals | |
| Nurses "usually" listened carefully2024-10-01 to 2025-09-30 · 370 cases | 17 | 19 | 19.31 | ||
| Nurses "always" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 370 cases | 86 | 86 | 86 | Worse than 47% of US hospitals | |
| Nurses "sometimes" or "never" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 370 cases | 3 | 3 | 2.385 | Worse than 50% of US hospitals | |
| Nurses "usually" treated them with courtesy and respect2024-10-01 to 2025-09-30 · 370 cases | 11 | 11 | 11.62 | ||
| "Always" quiet at night2024-10-01 to 2025-09-30 · 370 cases | 56 | 59 | 53.73 | Worse than 60% of US hospitals | |
| "Sometimes" or "never" quiet at night2024-10-01 to 2025-09-30 · 370 cases | 11 | 9 | 12.33 | Worse than 60% of US hospitals | |
| "Usually" quiet at night2024-10-01 to 2025-09-30 · 370 cases | 33 | 31 | 33.93 | ||
| Quietness - linear mean score2024-10-01 to 2025-09-30 · 370 cases | 80 | 82 | 78.54 | Worse than 59% of US hospitals | |
| Quietness - star rating2024-10-01 to 2025-09-30 · 370 cases | 3 | 3 | 2.769 | Worse than 44% of US hospitals | |
| "NO", patients would not recommend the hospital (they probably would not or definitely would not recommend it)2024-10-01 to 2025-09-30 · 370 cases | 5 | 5 | 5 | Better than 45% of US hospitals | |
| "YES", patients would definitely recommend the hospital2024-10-01 to 2025-09-30 · 370 cases | 77 | 71 | 71.93 | Better than 69% of US hospitals | |
| Recommend hospital - linear mean score2024-10-01 to 2025-09-30 · 370 cases | 90 | 87 | 88.31 | Better than 68% of US hospitals | |
| "YES", patients would probably recommend the hospital2024-10-01 to 2025-09-30 · 370 cases | 18 | 23 | 23.07 | ||
| Recommend hospital - star rating2024-10-01 to 2025-09-30 · 370 cases | 4 | 4 | 3.923 | Better than 42% of US hospitals | |
| Staff "always" explained possible side effects2024-10-01 to 2025-09-30 · 370 cases | 46 | 47 | 49.69 | Worse than 53% of US hospitals | |
| Staff "sometimes" or "never" explained possible side effects2024-10-01 to 2025-09-30 · 370 cases | 29 | 30 | 27.62 | Better than 55% of US hospitals | |
| Staff "usually" explained possible side effects2024-10-01 to 2025-09-30 · 370 cases | 25 | 22 | 22.69 | ||
| Summary star rating2024-10-01 to 2025-09-30 · 370 cases | 3 | 3 | 3.462 | Worse than 40% of US hospitals | |
| No, staff "did not" give patients information about possible symptoms2024-10-01 to 2025-09-30 · 370 cases | 16 | 12 | 11.92 | Worse than 81% of US hospitals | |
| Yes, staff "did" give patients information about possible symptoms2024-10-01 to 2025-09-30 · 370 cases | 84 | 88 | 88.08 | Worse than 81% of US hospitals |
How often the hospital gave recommended care, and how fast.
| Measure | This hospital | US median | HI average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Emergency department volume2024-01-01 to 2024-12-31 | low | ||||
| Global Malnutrition Composite Score2024-01-01 to 2024-12-31 | Not Available | ||||
| Global Malnutrition Composite Score: Malnutrition Diagnosis Documented2024-01-01 to 2024-12-31 | Not Available | ||||
| Global Malnutrition Composite Score: Malnutrition Risk Screening2024-01-01 to 2024-12-31 | Not Available | ||||
| Global Malnutrition Composite Score: Nutrition Assessment2024-01-01 to 2024-12-31 | Not Available | ||||
| Global Malnutrition Composite Score: Nutritional Care Plan2024-01-01 to 2024-12-31 | Not Available | ||||
| Hospital Harm - Severe Hyperglycemia2024-01-01 to 2024-12-31 | Not Available | 4.6 | |||
| Hospital Harm - Severe Hypoglycemia2024-01-01 to 2024-12-31 | Not Available | 0.25 | |||
| Hospital Harm - Opioid Related Adverse Events2024-01-01 to 2024-12-31 | Not Available | 0 | |||
| Healthcare workers given influenza vaccination2024-10-01 to 2025-03-31 · 652 cases | 67 | 79 | 65.63 | Worse than 68% of US hospitals | |
| Average (median) time all patients spent in the emergency department before leaving from the visit, including psychiatric/mental health patients and patients who were transferred to another facility. A lower number of minutes is better2024-10-01 to 2025-09-30 · 382 cases | 137 | 154 | 119 | Better than 64% of US hospitals | |
| Average (median) time patients spent in the emergency department before leaving from the visit, excluding patients transferred to another facility or psychiatric care/mental health patients. A lower number of minutes is better2024-10-01 to 2025-09-30 · 367 cases | 135 | 148 | 120 | Better than 60% of US hospitals | |
| Average (median) time psychiatric/mental health patients spent in the emergency department before leaving from the visit. A lower number of minutes is better2024-10-01 to 2025-09-30 · 12 cases | 291 | 247 | 196 | Worse than 65% of US hospitals | |
| Average (median) time patients spent in the emergency department before being transferred to another facility. A lower number of minutes is better2024-10-01 to 2025-09-30 | Not Available | 277 | |||
| Left before being seen2024-01-01 to 2024-12-31 · 18,493 cases | 1 | 1 | 0.8824 | Better than 42% of US hospitals | |
| Head CT results2024-10-01 to 2025-09-30 · 13 cases | 85 | 74 | 68.14 | Better than 75% of US hospitals | |
| Endoscopy/polyp surveillance: appropriate follow-up interval for normal colonoscopy in average risk patients2024-01-01 to 2024-12-31 · 66 cases | 94 | 97 | 91.73 | Worse than 65% of US hospitals | |
| Improvement in Patient's Visual Function within 90 Days Following Cataract Surgery2024-01-01 to 2024-12-31 | Not Available | ||||
| ST-Segment Elevation Myocardial Infarction (STEMI)2024-01-01 to 2024-12-31 | Not Available | ||||
| Safe Use of Opioids - Concurrent Prescribing2024-01-01 to 2024-12-31 · 386 cases | 10 | 15 | 11.31 | Better than 82% of US hospitals | |
| Appropriate care for severe sepsis and septic shock2024-10-01 to 2025-09-30 · 115 cases | 82 | 65 | 76.08 | Better than 88% of US hospitals | |
| Septic Shock 3-Hour Bundle2024-10-01 to 2025-09-30 · 38 cases | 95 | 73 | 85 | Better than 93% of US hospitals | |
| Septic Shock 6-Hour Bundle2024-10-01 to 2025-09-30 · 22 cases | 95 | 88 | 87.36 | Better than 74% of US hospitals | |
| Severe Sepsis 3-Hour Bundle2024-10-01 to 2025-09-30 · 116 cases | 90 | 82 | 90.67 | Better than 81% of US hospitals | |
| Severe Sepsis 6-Hour Bundle2024-10-01 to 2025-09-30 · 81 cases | 93 | 94 | 92.92 | Worse than 55% of US hospitals | |
| Discharged on Antithrombotic Therapy2024-01-01 to 2024-12-31 · 47 cases | 98 | 98 | 95.7 | Better than 49% of US hospitals | |
| Anticoagulation Therapy for Atrial Fibrillation/Flutter2024-01-01 to 2024-12-31 | Not Available | 71.75 | |||
| Antithrombotic Therapy by End of Hospital Day 22024-01-01 to 2024-12-31 · 32 cases | 97 | 94 | 92.86 | Better than 73% of US hospitals | |
| Venous Thromboembolism Prophylaxis2024-01-01 to 2024-12-31 | Not Available | 70.5 | |||
| Intensive Care Unit Venous Thromboembolism Prophylaxis2024-01-01 to 2024-12-31 · 285 cases | 65 | 97 | 88.33 | Worse than 97% of US hospitals |
How often scans were ordered when they may not be needed; lower is better.
| Measure | This hospital | US median | HI average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Abdomen CT Use of Contrast Material2024-07-01 to 2025-06-30 | 3.8 | 5 | 4.446 | Better than 64% of US hospitals | |
| Breast Cancer Screening Recall Rates2024-07-01 to 2025-06-30 | 7.7 | 6.6 | 6.189 | Worse than 63% of US hospitals |
Medicare spending around an inpatient stay compared with the US (1 is the US median).
| Measure | This hospital | US median | HI average | CMS comparison | US rank |
|---|---|---|---|---|---|
| Medicare hospital spending per patient (Medicare Spending per Beneficiary)2024-01-01 to 2024-12-31 | 0.85 | 0.99 | 0.8855 | Better than 95% of US hospitals |
The scores Medicare uses to raise or lower inpatient payments; higher is better.
| Measure | This hospital | US median | HI average | CMS comparison | US rank |
|---|---|---|---|---|---|
| VBP clinical outcomes domain scoreFY 2026 | 35 | 20 | 20.86 | Better than 76% of US hospitals | |
| VBP clinical outcomes weighted domain scoreFY 2026 | 8.75 | 5 | 5.216 | Better than 75% of US hospitals | |
| VBP efficiency and cost reduction domain scoreFY 2026 | 100 | 10 | 61.82 | The best result, shared by 2% of US hospitals | |
| VBP efficiency and cost reduction weighted domain scoreFY 2026 | 25 | 2.5 | 15.45 | Better than 97% of US hospitals | |
| VBP person and community engagement domain scoreFY 2026 | 31 | 34 | 38.64 | Worse than 56% of US hospitals | |
| VBP person and community engagement weighted domain scoreFY 2026 | 7.75 | 8.75 | 9.659 | Worse than 56% of US hospitals | |
| VBP safety domain scoreFY 2026 | 25 | 40 | 42.33 | Worse than 78% of US hospitals | |
| VBP safety weighted domain scoreFY 2026 | 6.25 | 10 | 10.58 | Worse than 78% of US hospitals | |
| VBP total performance scoreFY 2026 | 47.75 | 29.5 | 40.91 | Better than 91% of US hospitals |
| By fiscal year | FY 2021 | FY 2022 | FY 2023 | FY 2024 | FY 2025 | FY 2026 |
|---|---|---|---|---|---|---|
| VBP clinical outcomes domain score | 27.5 | 56.67 | Not Available | 0 | 0 | 35 |
| VBP clinical outcomes weighted domain score | 9.167 | 14.17 | Not Available | 0 | 0 | 8.75 |
| VBP efficiency and cost reduction domain score | 60 | Not Available | 80 | 60 | 80 | 100 |
| VBP efficiency and cost reduction weighted domain score | 20 | Not Available | 20 | 20 | 26.67 | 25 |
| VBP person and community engagement domain score | 54 | Not Available | Not Available | 12 | 15 | 31 |
| VBP person and community engagement weighted domain score | 18 | Not Available | Not Available | 4 | 5 | 7.75 |
| VBP safety domain score | Not Available | Not Available | Not Available | Not Available | Not Available | 25 |
| VBP safety weighted domain score | Not Available | Not Available | Not Available | Not Available | Not Available | 6.25 |
| VBP total performance score | 47.17 | Not Available | Not Available | 24 | 31.67 | 47.75 |
Excess readmission ratios by condition; above 1 means more readmissions than expected.
| Measure | This hospital | US median | HI average | CMS comparison | US rank |
|---|---|---|---|---|---|
| READM-30-AMI-HRRP2021-07-01 to 2024-06-30 | N/A | 1.005 | |||
| READM-30-CABG-HRRP2021-07-01 to 2024-06-30 | N/A | 0.9704 | |||
| READM-30-COPD-HRRP2021-07-01 to 2024-06-30 | N/A | 0.9963 | |||
| READM-30-HF-HRRP2021-07-01 to 2024-06-30 | 0.9538 | 0.9983 | 1.003 | Better than 79% of US hospitals | |
| READM-30-HIP-KNEE-HRRP2021-07-01 to 2024-06-30 | N/A | 0.9556 | |||
| READM-30-PN-HRRP2021-07-01 to 2024-06-30 | 0.9266 | 0.9955 | 0.9561 | Better than 89% of US hospitals |
| By fiscal year | FY 2021 | FY 2022 | FY 2023 | FY 2024 | FY 2025 | FY 2026 |
|---|---|---|---|---|---|---|
| READM-30-AMI-HRRP | N/A | N/A | N/A | N/A | N/A | N/A |
| READM-30-CABG-HRRP | N/A | N/A | N/A | N/A | N/A | N/A |
| READM-30-COPD-HRRP | 0.9526 | 0.9553 | N/A | N/A | N/A | N/A |
| READM-30-HF-HRRP | 1.048 | 1.055 | 1.071 | 1.005 | 0.984 | 0.9538 |
| READM-30-HIP-KNEE-HRRP | 1.025 | 0.9861 | N/A | N/A | N/A | N/A |
| READM-30-PN-HRRP | 0.9986 | 0.9852 | 0.9546 | 0.9443 | 0.935 | 0.9266 |
Infection ratios, the PSI 90 composite and the total score Medicare ranks hospitals on; lower is better.
| Measure | This hospital | US median | HI average | CMS comparison | US rank |
|---|---|---|---|---|---|
| CAUTI standardized infection ratio2023-01-01 to 2024-12-31 | 2.836 | 0.489 | 0.9801 | Worse than 99% of US hospitals | |
| CDI standardized infection ratio2023-01-01 to 2024-12-31 | 1.808 | 0.346 | 0.5455 | Worse than 99% of US hospitals | |
| CLABSI standardized infection ratio2023-01-01 to 2024-12-31 | 2.151 | 0.559 | 0.8835 | Worse than 99% of US hospitals | |
| HAC Reduction Program payment reductionFY 2026 | Yes | ||||
| MRSA standardized infection ratio2023-01-01 to 2024-12-31 | N/A | 0.4982 | |||
| Patient safety and adverse events composite (PSI 90)2022-07-01 to 2024-06-30 | 0.9606 | 0.9628 | 1.068 | Better than 51% of US hospitals | |
| SSI standardized infection ratio2023-01-01 to 2024-12-31 | 2.455 | 0.7945 | 1.393 | Worse than 97% of US hospitals | |
| Total HAC scoreFY 2026 | 1.759 | -0.0453 | 0.4309 | Worse than 98% of US hospitals |
| By fiscal year | FY 2021 | FY 2022 | FY 2023 | FY 2024 | FY 2025 | FY 2026 |
|---|---|---|---|---|---|---|
| HAC Reduction Program payment reduction | Yes | No | N/A | No | Yes | Yes |
| Total HAC score | 0.509 | -0.6163 | 0 | -0.8818 | 1.144 | 1.759 |
Source: CMS Care Compare hospital files, latest release 2026-09-30, with program results for earlier fiscal years from CMS's archived snapshots. US medians and ranks count every hospital CMS reports; state averages are plain means of the state's reporting hospitals, not CMS's patient-weighted state rates.
The Joint Commission (since 2010)
Accreditation
None
Medical school affiliation
Private (not for profit)
Ownership type
33
Medicare-certified beds
61
Registered nurses (full-time equivalent)
1996
In Medicare since
Source: CMS Provider of Services file, as reported by the hospital and state surveyors.
What North Hawaii Community Hospital reported to Medicare in its latest cost report, covering Jul 1, 2024 to Jun 30, 2025.
1,899
Inpatient discharges
Medicare 17%, Medicaid 27%
6,841
Inpatient days
57% of available bed days used
271
Employees (full-time equivalent)
Source: CMS cost report (HCRIS) (report 825752). Figures cover the reporting period, which is not always 12 months, and are self-reported.
Inpatient days and discharges North Hawaii Community Hospital reported by payer. Medicare and Medicaid include their managed care plans, shown separately below.
| Medicare | Medicaid | Other | Total | |
|---|---|---|---|---|
| Inpatient days | 1,637 | 1,995 | 3,209 | 6,841 |
| Discharges | 330 | 512 | 1,057 | 1,899 |
| Average length of stay | 5.0 days | 3.9 days | 3.0 days | 3.6 days |
| Average daily census | 4.5 | 5.5 | 8.8 | 18.7 |
| Unit | Beds | Inpatient days | Medicare days | Occupancy |
|---|---|---|---|---|
| Adults & pediatrics | 29 | 5,401 | 1,431 | 51% |
| Intensive care unit | 4 | 749 | 206 | 51% |
| Nursery | 691 |
Source: CMS cost report (HCRIS, Form 2552-10), report 825752, as submitted. Hospitals report these figures themselves; they are not audited financial statements. Worksheet S-3 Part I.
What North Hawaii Community Hospital treats Medicare patients for most often, in 2024. 121 Medicare discharges in 7 published DRGs; 0% surgical; 79% in DRGs with complications (CC or MCC).
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 27 | $60,402 | $11,046 | $13,107 | 1.28 |
| Septicemia or severe sepsis without MV >96 hours with MCCMS-DRG 871, medical | 21 | $94,943 | $21,642 | $20,603 | 1.98 |
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 20 | $48,691 | $11,796 | $10,566 | 1.33 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 15 | $57,204 | $14,261 | $12,413 | 1.70 |
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 15 | $36,193 | $7,653 | $7,854 | 0.79 |
| Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursMS-DRG 065, medical | 12 | $55,206 | $8,977 | $11,980 | 1.02 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 11 | $62,653 | $12,652 | $13,596 | 1.23 |
Source: CMS Medicare Inpatient Hospitals by Provider and Service (2024 data, released 2026-04-10), traditional Medicare only; CMS omits DRGs with fewer than 11 discharges. Estimated cost is average charges times the hospital's Medicare cost-to-charge ratio from the IPPS Impact File. Weights are the MS-DRG relative weights for the same year.
The comprehensive outpatient service groups (APCs) North Hawaii Community Hospital billed Medicare for most in 2024: 328 services in all.
| Service group | Services | Patients | Average charges | Average Medicare payment | US average payment |
|---|---|---|---|---|---|
| Level 5 Musculoskeletal ProceduresAPC 5115 | 63 | 61 | $54,405 | $14,316 | $10,772 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 55 | 55 | $10,207 | $1,561 | $1,220 |
| Comprehensive Observation ServicesAPC 8011 | 49 | 47 | $22,002 | $2,636 | $2,090 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 33 | 32 | $11,473 | $1,519 | $1,196 |
| Level 1 Abdominal/Peritoneal/Biliary and Related ProceduresAPC 5341 | 27 | 27 | $25,334 | $3,273 | $2,636 |
| Level 3 Vascular ProceduresAPC 5183 | 20 | 19 | $21,281 | $2,972 | $2,405 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 19 | 18 | $44,459 | $6,419 | $5,339 |
| Level 1 Laparoscopy and Related ServicesAPC 5361 | 19 | 19 | $30,890 | $5,663 | $4,358 |
| Level 1 Nerve ProceduresAPC 5431 | 18 | 15 | $12,592 | $1,892 | $1,407 |
| Level 3 Excision/ Biopsy/ Incision and DrainageAPC 5073 | 14 | 14 | $18,959 | $2,620 | $2,141 |
See all 11 Medicare outpatient services at North Hawaii Community Hospital
Source: CMS Medicare Outpatient Hospitals by Provider and Service (2024 data, released 2026-06-24), comprehensive APCs for traditional Medicare; CMS omits services with fewer than 11 claims. The US average weights every hospital by its services.
ZIP codes with the most Medicare inpatient stays at North Hawaii Community Hospital in 2025. Market share is this hospital's part of every hospital's Medicare stays from the ZIP code. Its published Medicare stays went from 299 in 2020 to 293 in 2025.
| ZIP code | Stays | Of this hospital's stays | Days | Charges | Market share | Share in 2020 |
|---|---|---|---|---|---|---|
| 96743 | 83 | 28% | 322 | $5.1M | 39% | 49% |
| 96727 | 62 | 21% | 305 | $4.9M | 52% | 49% |
| 96738 | 38 | 13% | 118 | $2.1M | 34% | 66% |
| 96740 | 33 | 11% | 144 | $2.4M | 4% | 4% |
| 96755 | 27 | 9% | 118 | $1.8M | 44% | 65% |
| 96776 | 22 | 8% | 92 | $1.6M | 61% | |
| 96719 | 17 | 6% | 82 | $1.2M | 61% | 100% |
| 96750 | 11 | 4% | 50 | $804,037 | 7% |
Source: CMS Hospital Service Area file. Shares are of the 293 stays from ZIP codes CMS publishes; it omits ZIP codes with fewer than 11 stays, so market shares count published stays only.
Staff by profession and the rooms and units North Hawaii Community Hospital reported at its latest Medicare certification survey (2013). Counts are people, not full-time equivalents.
5
Operating rooms
61
Registered nurses
2
Licensed practical nurses
11
Physicians
6
Nurse practitioners
1
Physician assistants
3
Nurse anesthetists (CRNAs)
4
Pharmacists
4
Respiratory therapists
4
Physical therapists
2
Occupational therapists
2
Speech pathologists and audiologists
3
Radiology technicians
2
Nuclear medicine technicians
1
Medical technologists
2
Dietitians
1
Social workers
2
Psychologists
Source: CMS Provider of Services file.
278 clinicians who bill Medicare list North Hawaii Community Hospital as a hospital affiliation. Showing 24 of them. Book a demo to see the commercial rates insurers publish for them, or start a free trial.
Joshua Rabang, MD
Diagnostic Radiology Physician
NPI 1952863888
See commercial rates for Joshua Rabang, MDLouis Pau, M.D.
Pain Medicine (Anesthesiology) Physician
NPI 1558311498
See commercial rates for Louis Pau, M.D.Alan Chan, MD
Diagnostic Radiology Physician
NPI 1609863240
See commercial rates for Alan Chan, MDSteven Johnson, M.D.
Diagnostic Radiology Physician
NPI 1518123041
See commercial rates for Steven Johnson, M.D.Bennett Abe, MD
Diagnostic Radiology Physician
NPI 1184731283
See commercial rates for Bennett Abe, MDScott Harada, M.D.
Diagnostic Radiology Physician
NPI 1649571548
See commercial rates for Scott Harada, M.D.Aimee Perreira, M.D.
Orthopaedic Hand Surgery Physician
NPI 1952560484
See commercial rates for Aimee Perreira, M.D.Samuel Huang, MD
Urology Physician
NPI 1679574081
See commercial rates for Samuel Huang, MDSydney Tatsuno, MD
Internal Medicine Physician
NPI 1467547307
See commercial rates for Sydney Tatsuno, MDJimmy Wang, M.D.
Diagnostic Radiology Physician
NPI 1205922689
See commercial rates for Jimmy Wang, M.D.Anthony Herrera, M.D.
Diagnostic Radiology Physician
NPI 1720220049
See commercial rates for Anthony Herrera, M.D.Pamela Tauchi-Nishi
Anatomic Pathology & Clinical Pathology Physician
NPI 1225082449
See commercial rates for Pamela Tauchi-NishiAlfredo Nino, M.D.
Diagnostic Radiology Physician
NPI 1164489258
See commercial rates for Alfredo Nino, M.D.Wesley Kim
Anatomic Pathology & Clinical Pathology Physician
NPI 1427005743
See commercial rates for Wesley KimClayton Yamada, MD
Diagnostic Radiology Physician
NPI 1134166739
See commercial rates for Clayton Yamada, MDHiroko Shinoda, M.D.
Anatomic Pathology & Clinical Pathology Physician
NPI 1326243239
See commercial rates for Hiroko Shinoda, M.D.Donald Blair, MD
Diagnostic Radiology Physician
NPI 1477523710
See commercial rates for Donald Blair, MDBoyd Hatton, M.D.
Diagnostic Radiology Physician
NPI 1699865543
See commercial rates for Boyd Hatton, M.D.Koah Vierkoetter, MD
Anatomic Pathology & Clinical Pathology Physician
NPI 1881989754
See commercial rates for Koah Vierkoetter, MDPaul Morton, MD
Orthopaedic Surgery Physician
NPI 1669736989
See commercial rates for Paul Morton, MDNicholas Kennedy, M.D.
Vascular & Interventional Radiology Physician
NPI 1447416235
See commercial rates for Nicholas Kennedy, M.D.Wichit Sae-Ow, M.D.
Anatomic Pathology & Clinical Pathology Physician
NPI 1346551983
See commercial rates for Wichit Sae-Ow, M.D.Michael Chervonski, M.D.
Vascular & Interventional Radiology Physician
NPI 1336405018
See commercial rates for Michael Chervonski, M.D.Chuong Nguyen, MD
Vascular & Interventional Radiology Physician
NPI 1396717690
See commercial rates for Chuong Nguyen, MDSource: CMS Doctors and Clinicians facility affiliations, released 2026-10-15, with names and specialties from NPPES. Affiliation means the clinician bills Medicare for care at this hospital; it is not employment.
Revenue, expenses and income North Hawaii Community Hospital reported to Medicare for Jul 1, 2024 to Jun 30, 2025. Percentages are of net patient revenue.
| Line | Amount | Share |
|---|---|---|
| Gross patient revenue (charges) | $366.3M | 334.4% |
| Inpatient | $117.8M | 107.6% |
| Outpatient | $248.5M | 226.9% |
| Contractual allowances and discounts | -$256.8M | -234.4% |
| Net patient revenue | $109.5M | 100.0% |
| Operating expenses | -$109.4M | -99.9% |
| Operating income from patient care | $89,202 | 0.1% |
| Other income | $3.7M | 3.4% |
| Contributions and donations | $1.1M | 1.0% |
| Investment income | $42,087 | 0.0% |
| Other | $2.6M | 2.4% |
| Other expenses | -$4,000 | -0.0% |
| Net income | $3.8M | 3.5% |
| Line | Amount | Share |
|---|---|---|
| Traditional Medicare | $58M | 16.3% |
| Medicaid (including managed care) | $72M | 20.2% |
| Other payers and self-pay | $226.8M | 63.6% |
| Total charges | $356.9M | 100.0% |
Source: CMS cost report (HCRIS, Form 2552-10), report 825752, as submitted. Hospitals report these figures themselves; they are not audited financial statements. Traditional Medicare is the program charges on Worksheets D-3 and D Part V; Medicaid is from Worksheet S-10.
Computed from North Hawaii Community Hospital's latest cost report.
0.1%
Operating margin
Operating income from patient care / net patient revenue
3.4%
Total margin
Net income / net patient revenue plus other income
7.4%
EBITDAR margin
Net income before interest, depreciation and leases (Worksheet A-7), / total revenue
46% of expenses
Personnel costs
Salaries, direct-care contract labor and core wage-related costs / operating expenses
$59.88
Average hourly wage
Adjusted salaries / paid hours (Worksheet S-3 Part II)
1.8%
Return on assets
Net income for a year / total assets
3.1%
Return on equity
Net income for a year / fund balance
0.71
Current ratio
Current assets / current liabilities
0.32
Quick ratio
Cash, temporary investments and net receivables / current liabilities
1 days
Days cash on hand
Cash and temporary investments / daily operating expenses excluding depreciation
46 days
Days in patient receivables
Net patient receivables / daily net patient revenue
150 days
Average payment period
Current liabilities / daily operating expenses excluding depreciation
0.52
Asset turnover
Total revenue for a year / total assets
17.5 years
Average age of plant
Accumulated depreciation / depreciation for a year
Source: CMS cost report (HCRIS, Form 2552-10), report 825752, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
What North Hawaii Community Hospital owned and owed at the end of its reporting period (Jun 2025), across all fund types: $217.8M in total assets and a $122.7M fund balance.
| Line | Amount | Of total assets |
|---|---|---|
| Cash and temporary investments | $204,674 | 0.1% |
| Patient receivables, net | $13.7M | 6.3% |
| Inventory | $1.9M | 0.9% |
| Total current assets | $30.7M | 14.1% |
| Property and equipment, net of depreciation | $60.3M | 27.7% |
| Investments and other assets | $126.8M | 58.2% |
| Total assets | $217.8M | 100.0% |
| Current liabilities | $43.4M | 19.9% |
| Total liabilities | $95.1M | 43.7% |
| Fund balance (net assets) | $122.7M | 56.3% |
Source: CMS cost report (HCRIS, Form 2552-10), report 825752, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Care North Hawaii Community Hospital provided without full payment, as reported on Worksheet S-10 of its cost report.
$330,054
Cost of charity care
Care for patients approved for charity care and uninsured discounts, at cost
$3.8M
Bad debt
Patient bills written off as uncollectible, at charges
$7.4M
Medicaid shortfall
Cost of Medicaid patients (charges times the cost-to-charge ratio) minus Medicaid payments; negative means a surplus
$5.1M
Total unreimbursed and uncompensated care
4.6% of operating expenses
Medicaid, CHIP and indigent care shortfalls plus charity care and the cost of bad debt (Worksheet S-10 line 31)
Source: CMS cost report (HCRIS, Form 2552-10), report 825752, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
North Hawaii Community Hospital's full-year cost reports, by fiscal year end. Reports shorter than ten months are left out.
| Fiscal year ending | Jun 2020 | Jun 2021 | Jun 2022 | Jun 2023 | Jun 2024 | Jun 2025 |
|---|---|---|---|---|---|---|
| Net patient revenue | $72.9M | $80.1M | $84.5M | $93.8M | $102.4M | $109.5M |
| Operating expenses | $80M | $85.1M | $89M | $94.9M | $101.4M | $109.4M |
| Operating margin | -9.7% | -6.3% | -5.3% | -1.1% | 1.0% | 0.1% |
| Net income | $5.6M | $1.4M | -$46.7M | $4.6M | $7.2M | $3.8M |
| Total assets | $242M | $240.3M | $242.2M | $229.2M | $211.5M | $217.8M |
| Discharges | 1,601 | 1,571 | 1,688 | 1,920 | 1,966 | 1,899 |
| Inpatient days | 4,840 | 5,099 | 6,115 | 7,213 | 6,625 | 6,841 |
| Beds | 33 | 33 | 33 | 33 | 33 | 33 |
| Employees (FTE) | 256 | 259 | 256 | 250 | 270 | 271 |
Source: CMS cost report (HCRIS, Form 2552-10), report 825752, as submitted. Hospitals report these figures themselves; they are not audited financial statements.
Each cost center North Hawaii Community Hospital reports, largest first. Total cost includes its share of overhead; the cost-to-charge ratio is total cost / charges.
| Department | Salaries | Total cost | Charges | Cost-to-charge | Square feet |
|---|---|---|---|---|---|
| Drugs charged to patients | $15.5M | $46.3M | 0.33 | ||
| Radiology-diagnostic | $4.2M | $11.2M | $55.9M | 0.20 | 10,346 |
| Operating room | $2.6M | $8.2M | $55.2M | 0.15 | 7,714 |
| Rural health clinic ii | $3.6M | $7.6M | $6.5M | 1.16 | 3,364 |
| Emergency | $3M | $7.4M | $70.1M | 0.10 | 3,091 |
| Laboratory | $4.6M | $27M | 0.17 | 5,228 | |
| Rural health clinic | $2.3M | $4.1M | $3.8M | 1.09 | 4,425 |
| Home health agency | $2.1M | $4.1M | $2.2M | 1.88 | 1,416 |
| Medical supplies charged to patient | $4M | $3.4M | 1.17 | ||
| Physical therapy | $1.3M | $2.6M | $6.4M | 0.40 | 3,235 |
| Impl. dev. charged to patients | $2.6M | $5.8M | 0.44 | ||
| Respiratory therapy | $588,632 | $1.9M | $3.3M | 0.56 | 859 |
| Observation beds (non-distinct part | $1.1M | $3.2M | 0.34 | ||
| Delivery room & labor room | $1M | $2.7M | 0.38 | 1,014 | |
| Radioisotope | $33,377 | $696,476 | $899,272 | 0.77 | 975 |
| Diabetes wellness | $101,928 | $201,591 | $253,314 | 0.80 | 299 |
| Vaccination clinic | $628 |
| Department | Salaries | Total cost | Charges | Cost-to-charge | Square feet |
|---|---|---|---|---|---|
| Adults & pediatrics | $5.8M | $11.1M | $45M | 0.25 | 9,375 |
| Intensive care unit | $1.2M | $2.5M | $15M | 0.17 | 1,845 |
| Nursery | $169 | $1.2M | $3.7M | 0.32 | 1,282 |
| Department | Salaries | Direct cost | Paid hours | Average hourly wage | Square feet |
|---|---|---|---|---|---|
| Administrative & general | $3.2M | $16M | 77,539 | $41.45 | 59,969 |
| Cap rel costs-bldg & fixt | $4.7M | 143,847 | |||
| Operation of plant | $987,957 | $4.3M | 30,223 | $32.69 | 3,939 |
| Pharmacy | $1.1M | $1.9M | 19,144 | $59.42 | 1,348 |
| Nursing administration | $1.4M | $1.7M | 20,874 | $65.54 | 1,068 |
| Housekeeping | $550,610 | $1.4M | 26,704 | $20.62 | 685 |
| Dietary | $581,185 | $1.1M | 23,684 | $24.54 | 3,060 |
| Central services & supply | $406,003 | $768,507 | 14,450 | $28.10 | 4,023 |
| Employee benefits department | $420,274 | $645,223 | 6,397 | $65.70 | 1,218 |
| Medical records & library | $119,442 | $209,484 | 5,083 | $23.50 | 1,000 |
| Laundry & linen service | $102,292 | $203,118 | 4,829 | $21.18 | 1,500 |
| Cap rel costs-mvble equip | $190,387 |
Source: CMS cost report (HCRIS, Form 2552-10), report 825752, as submitted. Hospitals report these figures themselves; they are not audited financial statements. Worksheets A, B-1, C Part I and S-3 Part II.
The factors Medicare uses to set what it pays North Hawaii Community Hospital for an inpatient stay.
1.50
Case mix index
Higher than 28% of hospitals paid under Medicare IPPS
Average Medicare DRG weight of its inpatient cases (FY 2027); higher means more complex, costlier care.
No Medicare-funded residents
Teaching status
Medicare-funded interns and residents per bed (FY 2027).
33.1%
Low-income patient share
Disproportionate share percentage: Medicaid and SSI patient days CMS uses for safety-net payments (FY 2027).
346
Medicare inpatient stays
Medicare claims CMS based FY 2027 payment rates on.
Rural
Location type
Geographic area CMS assigns before any wage index reclassification (FY 2027).
| IPPS fiscal year | FY 2021 | FY 2022 | FY 2023 | FY 2024 | FY 2025 | FY 2026 | FY 2027 |
|---|---|---|---|---|---|---|---|
| Case mix index | 1.68 | 1.68 | 1.65 | 1.67 | 1.66 | 1.50 | 1.50 |
| Wage index | 1.256 | 1.201 | 1.200 | 1.378 | 1.309 | 1.260 | 1.198 |
| Readmissions adjustment | -0.35% | -0.52% | -0.30% | -0.31% | -0.04% | 0.00% | 0.00% |
| Value-based purchasing adjustment | +0.22% | +1.03% | +1.03% | +0.14% | +0.28% | +0.83% | +1.29% |
| Medicare inpatient stays | 350 | 350 | 302 | 328 | 349 | 322 | 346 |
Source: CMS IPPS final rule Impact File (FY 2027).
Organizations North Hawaii Community Hospital reports to Medicare as owners or with operational control.
The Queen's Health Systems
5% or greater direct ownership interest, 100%, since 2014
Sources: CMS Hospital All Owners.
The officers and board members on North Hawaii Community Hospital's Medicare enrollment and on the IRS Form 990 filed under its tax ID.
Source: CMS Hospital All Owners (PECOS), the people the hospital lists on its Medicare enrollment; the first 12 of 13 are shown.
Queen'S North Hawaii Community Hospital files the Form 990 for the tax ID insurers list for North Hawaii Community Hospital, so these people may lead the wider organization rather than North Hawaii Community Hospital alone.
| Name | Title |
|---|---|
| Jill Hoggard Green | Trustee/chair |
| Cynthia Kamikawa | President/trustee |
| Money Atwal | Treasurer |
| Shariann Gonsalves | Secretary |
Board members: Jason Chang, Robert Hastings II, Neil Kuyper, Richard Levy PhD, Kahu Billy Mitchell, Robert Momsen, Jenai Wall, Kyle Chock, Robert Dean.
Source: IRS Form 990 Part VII filed by Queen'S North Hawaii Community Hospital (EIN 99-0260423), via the IRS e-file data. A health system's return can cover several hospitals.
340B drug pricing program
Participating since 2011
340B ID DSH120028, registered as a disproportionate share hospital; 2 active contract pharmacies. Authorizing official: Money Atwal, VP Qhs, Interim COO Qnhch.
Source: HRSA 340B Office of Pharmacy Affairs Information System.
Accountable care organization (Medicare Shared Savings Program)
QCIPN
ACO A4614, current agreement since 2025. Public reporting page
Source: CMS Shared Savings Program participants, 2026, matched on North Hawaii Community Hospital's legal name.
Helipad
Lucy Henriques Medical Center
FAA location ID HI18, a medical-use heliport at the hospital.
Source: FAA National Airspace System Resource data, cycle 2026-10-01.
Kohala home health
CCN 127019, certified 1997, Medicare prospective payment
Womens health
CCN 123981, certified 2018, Medicare cost reimbursed
Primary care
CCN 123982, certified 2018, Medicare cost reimbursed
Source: Worksheet S-2 Part I of North Hawaii Community Hospital's latest Medicare cost report (HCRIS).
About North Hawaii Community Hospital's rates and hospital price transparency.
For MRI brain before and after contrast (CPT 70553), published negotiated rates at North Hawaii Community Hospital range from $1,011 to $2,223 across 3 insurers. Aetna's rate is $1,011. What a patient pays depends on their plan's deductible, coinsurance and network status.
For CT abdomen and pelvis with contrast (CPT 74177), published negotiated rates at North Hawaii Community Hospital range from $1,116 to $2,655 across 3 insurers. Aetna's rate is $1,343. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Colonoscopy with polyp removal (CPT 45385), published negotiated rates at North Hawaii Community Hospital range from $4,032 to $8,850 across 2 insurers. HMSA Blue Cross Blue Shield's rate is $4,032. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Vaginal delivery, hospital stay (MS-DRG 807), published negotiated rates at North Hawaii Community Hospital range from $8,805 to $8,805 across 1 insurers. HMSA Blue Cross Blue Shield's rate is $8,805. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at North Hawaii Community Hospital range from $180 to $305 across 3 insurers. Aetna's rate is $180. What a patient pays depends on their plan's deductible, coinsurance and network status.
North Hawaii Community Hospital has a CMS overall hospital star rating of 3 out of 5 on Medicare Care Compare (CMS data released 2026-08-13). That is lower than 42% of US hospitals.
CMS reports no Medicare-funded interns or residents at North Hawaii Community Hospital for fiscal year 2027.
No. North Hawaii Community Hospital has no Hospital Readmissions Reduction Program penalty in fiscal year 2027.
In 2024, the most common were heart failure and shock with mcc (27 discharges), septicemia or severe sepsis without mv >96 hours with mcc (21 discharges), simple pneumonia and pleurisy with mcc (20 discharges).
North Hawaii Community Hospital's Medicare case mix index is 1.50 for fiscal year 2027, higher than 28% of hospitals paid under the inpatient prospective payment system.
North Hawaii Community Hospital reported 1,899 inpatient discharges and 6,841 inpatient days from Jul 1, 2024 to Jun 30, 2025.
North Hawaii Community Hospital reported 271 full-time-equivalent employees on payroll from Jul 1, 2024 to Jun 30, 2025.
North Hawaii Community Hospital reported $109.5M in net patient revenue on $366.3M of gross charges for Jul 1, 2024 to Jun 30, 2025, an operating margin of 0.1%, and net income of $3.8M.
North Hawaii Community Hospital reported $5.1M of unreimbursed and uncompensated care for Jul 1, 2024 to Jun 30, 2025, including $330,054 of charity care at cost.
North Hawaii Community Hospital's Medicare enrollment lists Stephany Vaioleti as President since 2023.
Insurers' price transparency files list North Hawaii Community Hospital under employer identification number 99-0260423 (Queens North Hawaii Community Hospital). 40 health plans and networks list 99-0260423 for it.
Yes. HRSA's 340B database lists North Hawaii Community Hospital (340B ID DSH120028) as a participating disproportionate share hospital since 2011, with 2 active contract pharmacies.
278 clinicians who bill Medicare list North Hawaii Community Hospital as a hospital affiliation in CMS's Doctors and Clinicians data. The largest groups are emergency medicine physician (24), family medicine physician (23), family nurse practitioner (22).
Yes. CMS's Provider of Services file lists The Joint Commission as the accrediting organization for North Hawaii Community Hospital, effective 2010.
In its Medicare enrollment, North Hawaii Community Hospital reports The Queen's Health Systems as 5% or greater direct ownership interest (100%).
CMS lists 36 services at North Hawaii Community Hospital, including Anesthesia, CARF Inpatient Rehabilitation (Commission On Accreditation Of Rehabilitation Facilities Inpatient Rehabilitation), Chemotherapy, Clinical Laboratory, Coronary Care Unit, CT Scan.
In CMS's 2025 Hospital Service Area file, the most Medicare inpatient stays at North Hawaii Community Hospital came from ZIP codes 96743 (83), 96727 (62), 96738 (38).
North Hawaii Community Hospital has 33 beds, including its psychiatric, rehabilitation and other subprovider units, in its latest Medicare cost report. Facility type: Short Term Acute Care Hospital.
North Hawaii Community Hospital is located at 67-1125 Mamalahoa Highway, Kamuela, HI 96743. Its main phone number is (808) 885-4444.
North Hawaii Community Hospital's CMS Certification Number (CCN), also called its Medicare provider number, is 120028.
The National Provider Identifier (NPI) on file for North Hawaii Community Hospital is 1477559029.
North Hawaii Community Hospital is affiliated with The Queens Health Systems.
North Hawaii Community Hospital lists 29 in-network payers, including Aetna, Ameri Health, Aspirus Health Plan, Avera Health Plans, and is Medicare-certified. Insurance acceptance may vary by plan, so confirm coverage with your insurer or the hospital's billing department.
224 disclosed rate categories. Each shows the payer, category, code type and group with its code range, and contract type, along with how the rate compares with the state average.
Under 45 CFR Part 180, every US hospital must publish a machine-readable file of its standard charges, including gross charges, discounted cash prices and payer-specific negotiated rates, in the CMS template format. PayerPrice can help hospitals publish and maintain these files.
A chargemaster (charge description master, or CDM) is a hospital's master list of billable items, with codes, descriptions and gross charges. A chargemaster review looks at those lines for accuracy and pricing. PayerPrice can help hospitals review their chargemaster; contact us to discuss your needs.
For hospital finance and compliance teams
The data on this page comes from the files hospitals and payers publish. We help hospitals publish theirs correctly, and take a fresh look at their chargemaster.
We turn your chargemaster and payer contracts into the CMS template file, then keep it current as rates change.
{
"description": "MRI of brain (no contrast)",
"code_information": [
{ "code": "611", "type": "RC" },
{ "code": "70551", "type": "CPT" }
],
"standard_charges": [{
"setting": "outpatient",
"minimum": 250,
"maximum": 400,
"gross_charge": 1200,
"discounted_cash": 1080,
"payers_information": [
{
"payer_name": "Platform Health Insurance",
"plan_name": "PPO",
"methodology": "fee schedule",
"standard_charge_dollar": 400
},
{
"payer_name": "Region Health Insurance",
"plan_name": "HMO",
"methodology": "fee schedule",
"standard_charge_dollar": 250
}
]
}]
}Your chargemaster sets the gross charge on every claim, and many payer contracts base payment on it through percent-of-charge, lesser-of and stop-loss terms. We audit it line by line and show how your charges and negotiated rates compare with peer hospitals before your next negotiation.
What a review covers