来源类型 | Research Reports
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规范类型 | 报告
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DOI | https://doi.org/10.7249/RR1809
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ISBN | 9780833097088
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来源ID | RR-1809-CPH
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| Evaluating the Impact of Policies to Regulate Involuntary Out-of-Network Charges on New Jersey Hospitals |
| Soeren Mattke; Chapin White; Mark Alan Hanson; Virginia Kotzias
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发表日期 | 2016
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出版年 | 2016
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页码 | 12
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语种 | 英语
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结论 |
Effects of Caps on Payment for Involuntary Out-of-Network Services- Among hospitals in New Jersey, revenues from involuntary out-of-network services accounted for less than 20 percent of commercial revenues but almost 40 percent of profits.
- The authors' estimates suggest that implementing New Jersey Bill A1952, which proposes a limit of between 90 and 200 percent of Medicare rates for involuntary out-of-network hospital care, would have reduced payments for hospital care by commercial plans by between 6 and 10 percent during 2010 through 2014. Assuming no change in operating expenses and no recoupment of lost out-of-network revenues, the cap would have led to an operating loss at between 48 and 70 percent of hospitals.
- The authors also estimated that a 1-percent reduction of out-of-network rates because of the caps would reduce negotiated in-network rates by half a percent, as it would weaken hospitals' bargaining position.
All-Payer Blended Rates- An alternative payment model to reduce high charges for involuntary out-of-network services could be the approach used in Maryland, under which a uniform rate is set for all payers, with a 6-percent discount to public payers. A 14-percent discount for public payers relative to commercial payers would make this model budget-neutral for public payers and hold hospital margins constant but would increase payments by commercial insurers by about 10 percent.
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主题 | Health Care Payment Approaches
; Health Legislation
; Hospitals
; Medicare
; New Jersey
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URL | https://www.rand.org/pubs/research_reports/RR1809.html
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来源智库 | RAND Corporation (United States)
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引用统计 |
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资源类型 | 智库出版物
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条目标识符 | http://119.78.100.153/handle/2XGU8XDN/108280
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推荐引用方式 GB/T 7714 |
Soeren Mattke,Chapin White,Mark Alan Hanson,et al. Evaluating the Impact of Policies to Regulate Involuntary Out-of-Network Charges on New Jersey Hospitals. 2016.
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