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Market Power: Price Variation Among Commercial Insurers For Hospital Services

机译:Market Power: Price Variation Among Commercial Insurers For Hospital Services

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摘要

Much research has focused on differences in hospital prices paid by private (commercial) versus public (Medicare and Medicaid) health insurers. Far less is known about price differences across commercial payers-health maintenance organizations (HMOs) or preferred provider organizations (PPOs) versus other payers, such as casualty (automobile), workers' compensation, and travel insurers. We found that other insurers had far less negotiating power with hospitals than commercial HMO/PPO insurers did. In the period 2010-16, the median price paid by HMO/PPO insurers for hospital services in Florida increased from 1.9 times to 2.5 times the Medicare price, respectively, while the median price paid by other insurers increased from 2.8 times to 3.8 times the Medicare price. Commercial HMO/PPO insurers' prices were similar across major hospital systems, regardless of ownership, while other insurers' prices differed substantially across systems. In 2016 the twenty hospitals with the highest prices (7.8-14.1 times the Medicare rate) for other insurers in Florida were all affiliated with the Hospital Corporation of America. These hospitals generated 24 percent of their commercial net revenue (median) from other payers, despite treating a relatively small proportion of patients covered by these payers. Protecting patients with other insurance from high hospital prices requires efforts by policy makers, hospitals, and insurers.

著录项

  • 来源
    《Health affairs》 |2018年第10期|1615-1622|共8页
  • 作者

    Bai Ge; Anderson Gerard F.;

  • 作者单位

    Johns Hopkins Carey Business Sch, Baltimore, MD 21202 USA;

    Johns Hopkins Bloomberg Sch Publ Hlth, Dept Hlth Policy & Management, Baltimore, MD USA;

  • 收录信息
  • 原文格式 PDF
  • 正文语种 英语
  • 中图分类 预防医学、卫生学;
  • 关键词

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