Trends In Hospital Prices Paid By Private Health Plans Varied Substantially Across The US

Commercial health plans pay higher prices than public payers for hospital care, which accounts for more than 5 percent of US gross domestic product. Crafting effective policy responses requires monitoring trends and identifying sources of variation. Relying on data from the Healthcare Provider Cost...

Full description

Saved in:
Bibliographic Details
Published in:Health affairs (Millwood, Va.) Va.), 2022-04, Vol.41 (4), p.516-17
Main Authors: Levinson, Zachary, Qureshi, Nabeel, Liu, Jodi L, Whaley, Christopher M
Format: Article
Language:English
Subjects:
Children & youth
Estimates
Expenditures
GDP
Gross Domestic Product
Growth rate
Health care
Health care expenditures
Health care industry
Health insurance
Hospital costs
Hospitalization
Indigent care
Information systems
Medicaid
Medicare
Prices
Pricing
Ratios
Referrals
Regions
Statistical data
Trends
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Commercial health plans pay higher prices than public payers for hospital care, which accounts for more than 5 percent of US gross domestic product. Crafting effective policy responses requires monitoring trends and identifying sources of variation. Relying on data from the Healthcare Provider Cost Reporting Information System, we describe how commercial hospital payment rates changed relative to Medicare rates during 2012-19 and how trends differed by hospital referral region (HRR). We found that average commercial-to-Medicare price ratios were relatively stable, but trends varied substantially across HRRs. Among HRRs with high price ratios in 2012, ratios increased by 38 percentage points in regions in the top quartile of growth and decreased by 38 percentage points in regions in the bottom quartile. Our findings suggest that restraining the growth rate of HRR commercial hospital price ratios to the national average during our sample period would have reduced aggregate spending by $39 billion in 2019.
ISSN:0278-2715
1544-5208
DOI:10.1377/hlthaff.2021.01476