The Big Business of Trauma: Man who fell off a ladder and cut his arm was billed more than $52,000

Ed Knight took a tumble off a ladder and cut his arm. He went to Chippenham Hospital in Richmond, Virginia, where he says a team of doctors and nurses swarmed. Thirty stitches and a few CT scans later, he was sent home.

But the shock didn’t end there. The trauma team treated Knight’s injury, and the cost for them to “activate” was $17,000, according to KHN.

“Basically, it was just a gash on my arm,” said Knight, 71. “The emergency team that they assembled didn’t really do anything.”

Still, with the trauma team activation cost and the cost of the three CR scans, Knight’s bill totaled $52,238. WellRithms, a claims consulting firm, looked at his medical records and concluded Knight should have only been charged $3,537.

The hospital Knight went to is owned by a for-profit chain – HCA Healthcare. It is the biggest U.S. hospital operator, along with the Department of Veterans Affairs, and it currently has trauma centers in more than half of its 179 hospitals. In some cases, the cost to “activate” a trauma team can be as high as $50,000 per patient.

HCA reflects a growing trend of hospitals pursuing a trauma designation by meeting standards set by the American College of Surgeons. From 2010 to 2020, the number of Level I and Level II trauma centers nationwide rose from 343 to 567.

It can be a community service as well as a profitable strategy.

“Once a hospital has a trauma designation, it can charge thousands of dollars in activation fees for the same care seen in the same emergency room,” said Stacie Sasso, executive director of the Health Services Coalition, a non-profit in Southern Nevada.

Knight, who is covered by Medicare, paid nothing out of pocket. After the KHN article was published, Chippenham Hospital reduced the bill, collecting $1,138 for his care.

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