Large Disparity Between What Private Insurers, Medicare Pay Hospitals Puts Stark Spotlight On Opaque Marketplace
“It’s eye-opening, really, not just for the employers,” said Gloria Sachdev, the chief executive of the Employers’ Forum of Indiana, a coalition that helped with the study. “It’s eye-opening for the hospitals.”
The New York Times:
Many Hospitals Charge Double Or Even Triple What Medicare Would Pay
In Indiana, a local hospital system, Parkview Health, charged private insurance companies about four times what the federal Medicare program paid for the same care, according to a study of hospital prices in 25 states released on Thursday by the nonprofit RAND Corp. Colorado employers were shocked to learn they were paying nearly eight times what the federal government did for outpatient services like an emergency room visit, an X-ray or a checkup with a specialist at Colorado Plains Medical Center, northeast of Denver. (Abelson, 5/9)
Modern Healthcare:
Employer Health Plans Pay Hospitals 241% Of Medicare
Private employer-sponsored health plans paid hospitals 241% of Medicare prices, on average, for the same services at the same hospitals in 2017, according to a RAND Health study of prices across 25 states. That average price relative to Medicare has increased since 2015 when it was 236%. The study also found that relative prices in 2017 for outpatient care far exceeded prices for inpatient services. (Livingston, 5/9)
The Wall Street Journal:
What Employers Pay Hospitals Varies Widely, Study Finds
Prices have long been a closely guarded secret between hospitals and the health insurers that negotiate them. But more employers are sharing the data to curb rising costs. Hospital inflation accounts for about one-fifth of the overall growth in U.S. health-care spending since 1960, according to the Centers for Medicare and Medicaid Services. Supporters of greater transparency say releasing pricing data will help control spending on care by arming the companies who pay hospitals with better information to negotiate reimbursement rates. (Evans, 5/9)
Kaiser Health News:
Market Muscle: Study Uncovers Differences Between Medicare And Private Insurers
The gap between Medicare and private plans — and how it plays out across the country — underscores a key point in how American health care is priced. Often, it has little to do with what it costs hospitals or doctors to provide medical care. “It’s about how much they can charge, how much the market can take,” said Ge Bai, an associate professor at the Johns Hopkins University Carey Business School who studies hospital prices but was not affiliated with the study. (Luthra, 5/9)
