Community mental health services cost in DE
What a community mental health services costs at DE hospitals — and the fair price to aim for.
Typical commercial prices here match the fair market benchmark (1.00×) after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Loss-Leader / Captive Ancillary Cross-Subsidizer
PAM Rehabilitation Hospital of Dover prices routine shoppable procedures near 5.8× Medicare (p50 1.16×) while skewing captive emergency, lab, and upper-quartile codes to 13.5× Medicare (p75 1.34×, +16% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 0.98× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 5% of shoppable procedures (25/100 Cash Honesty)
- CMS clinical safety score (54/100 safety score) with 72% patient recommendation
- Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 2.5× markup over Medicare rates
- Captive ER (2.9×) & laboratory (2.6×) services average 2.33× higher multiples than routine shoppable care (5.8×)
- Upper-quartile procedures (Q75 1.34×) jump +16% above the median procedure ratio (Q50 1.16×)
- Consolidated metro market (HHI 2,500) limits in-network hospital competition (Moderately Concentrated (1,500–2,500))
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
In general, DE hospitals charge above the fair price — worth shopping around here. how we calculate the BaseRate →
Compared with the rest of the country, DE’s fair BaseRate ($12) is below the national fair price of $17.
Cheapest DE hospitals for a community mental health services
Audit a Bill or Quote at DE Hospital Benchmark (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $14
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $14).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask DE Hospital Benchmark's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $12 Fair BaseRate ($7 Medicare)
Your bill ($38) is $26 above the denoised Fair BaseRate ($12) and 5.4× the $7 Medicare rate.