St Louis-John Cochran Va Medical Center vs Detroit (john D. Dingell) Va Medical Center

St Louis-John Cochran Va Medical Center is in Missouri; Detroit (john D. Dingell) Va Medical Center is in Michigan. Cross-state comparisons need to account for the Medicare wage-index adjustment, which can move payments by 30% between high-cost-of-living states and low-cost-of-living ones, before any hospital-specific factors enter. Average payments are close: $9,039 vs $9,372, only 4% apart. With cost close to tied, the quality measures do most of the work in the value-rubric comparison. St Louis-John Cochran Va Medical Center comes out slightly ahead.

With costs this close, the choice between these two hospitals turns on the quality measure set, geographic convenience, or insurance-network status rather than payment-per-procedure differences.