High-priced hospitals and other providers in Massachusetts account for roughly four out of every five dollars paid by health insurers, according to a report from the Massachusetts Center for Health Information and Analysis (pdf).
The CHIA conducted the report to find out how provider price variation in the state, particularly within the commercial market, was driving the overall increase of healthcare spending.
The report measured specific data on relative healthcare price, defined as a "comparison of the amount paid to a provider for a standard set of healthcare services relative to the network-wide average amount paid to the same type of providers in the payor's network."
Here are key findings from the CHIA's report:
• For acute-care hospitals, payors with larger market shares (e.g., Blue Cross Blue Shield of Massachusetts) generally had less price variation, while payors with smaller market shares (e.g., Fallon Community Health Plan) had wide price variation.
• Higher-priced providers accounted for 80 percent of health insurer payments because of their relatively higher prices and higher volume.
• Hospitals with higher relative prices tended to be academic medical centers, teaching hospitals, specialty hospitals and geographically isolated hospitals. Most lower-priced hospitals were disproportionate share hospitals.
• Brigham and Women's Hospital and Massachusetts General Hospital, both in Boston, were the two highest-priced providers.
The CHIA conducted the report to find out how provider price variation in the state, particularly within the commercial market, was driving the overall increase of healthcare spending.
The report measured specific data on relative healthcare price, defined as a "comparison of the amount paid to a provider for a standard set of healthcare services relative to the network-wide average amount paid to the same type of providers in the payor's network."
Here are key findings from the CHIA's report:
• For acute-care hospitals, payors with larger market shares (e.g., Blue Cross Blue Shield of Massachusetts) generally had less price variation, while payors with smaller market shares (e.g., Fallon Community Health Plan) had wide price variation.
• Higher-priced providers accounted for 80 percent of health insurer payments because of their relatively higher prices and higher volume.
• Hospitals with higher relative prices tended to be academic medical centers, teaching hospitals, specialty hospitals and geographically isolated hospitals. Most lower-priced hospitals were disproportionate share hospitals.
• Brigham and Women's Hospital and Massachusetts General Hospital, both in Boston, were the two highest-priced providers.
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