What does “cost” mean?

 

Inigo Montoya in The Princess Bride.

The concept of “cost” seems easy enough. Few things in healthcare are ever simple, and cost is one of those. In a hospital setting, there are at least three different ways to define “cost”:

  • For the hospital, it is the cost of providing the service. This usually includes operational cost as well as allocated overhead and capital costs.
  • For a payer, it often is the amount of the reimbursement or the payment to the hospital.
  • For a patient, “cost” might be the hospital’s billed charge amount after any discounts.

In The Princess Bride Inigo Montoya says, “You keep saying that word. I do not think it means what you think it means.”

Each version of “cost” will produce different amounts for any given service.  If a research paper or publication does not define “cost” or how it is calculated be wary. What you think the metric means might not be what you think.