Prices paid to hospitals for services provided to privately insured patients compared to Medicare rates varied widely among states in 2017, according to a new Rand Corp. study.
The study conducted by Rand and the Employers' Forum of Indiana, an employer-led healthcare coalition, examined the prices paid by private health plans to hospitals relative to Medicare at 1,598 hospitals in 25 states. Researchers looked at healthcare insurance claims for more than 4 million people, using data from self-insured employers, two state all- payer claims databases and records from health insurance plans.
Relative prices represent the negotiated allowed amounts paid per service, including amounts from the insurer and the patient, with adjustments based on the intensity of services, compared to the amounts that would have been paid for the same services provided by the same facilities by Medicare.
Here are the relative prices in 2017 by state, from highest to lowest:
Indiana: 311 percent
Wyoming: 307 percent
Maine: 283 percent
Wisconsin: 279 percent
Montana: 277 percent
Colorado: 269 percent
Texas: 244 percent
Georgia: 243 percent
Ohio: 241 percent
Washington: 237 percent
New Hampshire: 236 percent
Louisiana: 235 percent
North Carolina: 234 percent
New Mexico: 229 percent
Florida: 229 percent
Massachusetts: 228 percent
Illinois: 225 percent
Missouri: 221 percent
Kansas: 219 percent
Vermont: 217 percent
Tennessee: 208 percent
Kentucky: 186 percent
New York: 178 percent
Pennsylvania: 169 percent
Michigan: 156 percent
After the release of the study, the American Hospital Association expressed concerns about the analysis, including the sample size used. Read the statement here.
Read more about the study here.
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