California Hospitals Collect More From Uninsured Patients Than From Medicare, Study Finds

California hospitals collect a higher percentage of their listed charges from uninsured patients than from Medicare, according to a study published on Tuesday in Health Affairs, the San Francisco Chronicle reports. For the study, researchers from RAND and the University of Southern California analyzed data submitted to the state by hospitals from 2001 to 2005. The study found that from 2001 to 2002, hospitals collected on average 18% more of their charges from uninsured patients than from Medicare, and from 2004 to 2005, hospitals collected on average 20% more of the charges from uninsured patients.

Researchers concluded that the net prices paid by uninsured patients to hospitals increased from 2001 to 2005 because the uninsured paid the same or more than Medicare, and during that period, Medicare increased payments to hospitals by 13%. Glenn Melnick, a USC professor and RAND economist, said, "Hospitals have started to adjust prices to the uninsured somewhat, but not substantially," adding, "The study shows they continue to raise prices to the uninsured during this period."

However, hospital officials "criticized the study for failing to reflect recent changes the industry has implemented to provide some relief for the uninsured," according to the Chronicle. In addition, consumer advocates said that because the study relied on averages, it does not reflect that some individuals "diligently pay large bills while others don't pay at all" and that some can pay two to four times the rate paid by Medicare, according to Anthony Wright, executive director of Health Access California.

The study was funded by the USC Center for Health Financing, Policy and Management and the Robert Wood Johnson Foundation (Colliver, San Francisco Chronicle, 2/5).

An abstract of the study is available online.