Adcare Hospital of Worcester Inc
107 Lincoln Street, Worcester, MA 01605 · 5 Priced Procedures
Typical commercial prices here are +53% above the fair benchmark (1.53×) even after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Specialty Drug & Surgical Margin Engine
Adcare Hospital of Worcester Inc concentrates commercial margin in outpatient surgical suites (4.1× Medicare) and specialty drug infusions (3.8× Medicare) relative to routine diagnostics (3.6×). Comparing freestanding ambulatory surgery centers or specialty pharmacy options before treatment yields substantial savings.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 1.72× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 0% of shoppable procedures (50/100 Cash Honesty)
- CMS clinical safety score (73/100 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 4.1× markup over Medicare rates
- Commercial insurance median sits at 1.72× Fair BaseRate (3.3× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Specialty infusion drugs (J-codes) average 3.8× Medicare — verify per-unit billing on itemized statements
- Consolidated metro market (HHI 2,291) 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.
Procedure Prices at Adcare Hospital of Worcester Inc
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 5 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Behavioral health residential care HCPCS Code: H0011 | $625 | unverified |
| Psychotherapy session (45 minutes) CPT Code: 90834 | — | — |
| Family therapy session CPT Code: 90847 | — | — |
| Mental health services (assessment) HCPCS Code: H0031 | — | — |
| Group therapy session CPT Code: 90853 | — | — |
Audit a Bill or Quote at Adcare Hospital of Worcester Inc (Zero PHI Required)
Above Standard 400% FPL Financial-Assistance Ceiling
At 274% FPL, you exceed the standard 400% FPL tier, though medical-hardship caps (when bills exceed 10% of annual income) may still apply.
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Adcare Hospital of Worcester Inc'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 $364 Fair BaseRate ($211 Medicare)
Your bill ($1,570) is $1,206 above the denoised Fair BaseRate ($364) and 7.4× the $211 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Public IRS & CMS ownership records classify Adcare Hospital of Worcester Inc as a non-501(c)(3) facility. Federal 26 U.S.C. § 501(r) statutory charity-care caps apply specifically to tax-exempt nonprofit hospitals, though state hospital fair-pricing statutes and prompt-pay self-pay discounts may still apply.
Clinical Quality, Patient Experience & Infection Benchmarks
Healthcare-Associated Infections (CDC NHSN / CMS HAI)
1.00 SIR = National Predicted Baseline (Lower Is Safer)CMS Price Transparency Administrative Enforcement Log
Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Adcare Hospital of Worcester Inc. Prior administrative notices do not necessarily reflect current compliance status.
- 2025-12-19·administrative_or_closure
Closure Notice
Recorded - 2025-09-15·cap_corrective_action
CAP Request
Recorded
Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Adcare Hospital of Worcester Inc.
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.