Sunday, May 12, 2019

Random charts - hospital costs

 

"... Large price discrepancies exist between what private health plans pay for hospital services and what Medicare pays. RAND Corporation researchers used data from three sources — self-insured employers, state-based all-payer claims databases, and health plans — to assess $13 billion in hospital spending in terms of hospital price levels, variation, and trends from 2015 through 2017 in 25 states. In this report, prices reflect the negotiated allowed amount paid per service, including amounts from both the health plan and the patient, with adjustments for the intensity of services provided. These negotiated prices are then compared with Medicare reimbursement rates for the same procedures and facilities to determine relative prices…” 

Relative prices, including all hospitals and states in the analysis, rose from 236 percent of Medicare rates in 2015 to 241 percent of Medicare rates in 2017 
  • Relative prices varied twofold among states. Some states (Michigan, Pennsylvania, New York, and Kentucky) had relative prices in the range of 150 to 200 percent of Medicare rates; other states (Colorado, Montana, Wisconsin, Maine, Wyoming, and Indiana) had relative prices in the range of 250 to 300-plus percent of Medicare rates. 
  • Relative prices increased rapidly from 2015 to 2017 in Colorado and Indiana, but they fell over the same period in Michigan. 
  • Among hospital systems, prices varied nearly threefold, ranging from 150 percent of Medicare rates at the low end to 350 to 400-plus percent at the high end. 
Relative prices for hospital outpatient services were 293 percent of Medicare rates on average, far higher than the average relative price for inpatient care (204 percent of Medicare rates) 
  • However, eight states — Michigan, New York, Tennessee, Massachusetts, Louisiana, New Hampshire, Montana, and Maine — stand out as exceptions to this general finding, with relative prices that are roughly equal for inpatient and outpatient services.."

 
back to top