Trauma Activation Fees Vary Widely Across US Trauma Centers

Area of Science:

• Health Economics
• Trauma Care Systems
• Healthcare Policy

Background:

• Trauma activation fees are crucial for trauma centers to maintain 24/7 lifesaving care capabilities.
• Significant variability and lack of regulation in these fees have led to increased scrutiny.

Purpose of the Study:

• To systematically describe trauma activation fees across U.S. trauma centers (Level I-III) using the Hospital Price Transparency rule.
• To analyze fee variations by payer type and hospital characteristics.

Main Methods:

• Utilized the Turquoise Health database to extract trauma activation fees from U.S. trauma centers.
• Data was analyzed as of April 18, 2023, focusing on published fees and payer types.

Main Results:

• Only 38% of U.S. trauma centers have published their activation fees.
• Fees ranged dramatically, from $40 (Medicaid) to $28,893 (commercial payers).
• Larger, metropolitan, Western, and proprietary hospitals reported significantly higher fees (60% more than public hospitals).

Conclusions:

• The wide, unmerited variation in trauma activation fees suggests potential inequities in the current funding model.
• This variability may not be equitable for either trauma centers or the critically injured patients they serve.