| 来源类型 | Working Paper |
| 规范类型 | 报告 |
| DOI | 10.3386/w27490 |
| 来源ID | Working Paper 27490 |
| Variation in Health Care Prices Across Public and Private Payers | |
| Toren L. Fronsdal; Jay Bhattacharya; Suzanne Tamang | |
| 发表日期 | 2020-07-06 |
| 出版年 | 2020 |
| 语种 | 英语 |
| 摘要 | We study a unique all-payer data set spanning 38 states to examine the differences in inpatient reimbursement rates paid by traditional Medicare (TM), Medicare Advantage (MA), Medicaid, and private (under-65) insurers, and the differences in negotiated rates across the 60 largest private insurers. After controlling for enrollee and hospital mix, we find that private insurers pay 37 percent more than TM, and MA pays 10 percent more than TM for the five most common inpatient diagnoses. The correlation in risk-adjusted payments by private insurers and by TM at the same hospital for the same diagnosis is only 0.10. There is significant variation in negotiated prices within and across private payers. Among the five largest US insurers, the most expensive insurer negotiates prices that are 5-26 percent higher than the mean price for the 20 most common inpatient diagnoses. Additionally, we find a 10 percent increase in insurer market share corresponds to a 7 percent decrease in inpatient negotiated prices and a 10 percent decrease in the standard deviation of prices. This finding suggests that increased insurer market power allows payers to negotiate prospective payment contracts – rather than the more common fee-for-service payments – thereby offloading financial risk to providers. |
| 主题 | Financial Economics ; Financial Institutions ; Health, Education, and Welfare ; Health |
| URL | https://www.nber.org/papers/w27490 |
| 来源智库 | National Bureau of Economic Research (United States) |
| 引用统计 | |
| 资源类型 | 智库出版物 |
| 条目标识符 | http://119.78.100.153/handle/2XGU8XDN/585162 |
| 推荐引用方式 GB/T 7714 | Toren L. Fronsdal,Jay Bhattacharya,Suzanne Tamang. Variation in Health Care Prices Across Public and Private Payers. 2020. |
| 条目包含的文件 | ||||||
| 文件名称/大小 | 资源类型 | 版本类型 | 开放类型 | 使用许可 | ||
| w27490.pdf（882KB） | 智库出版物 | 限制开放 | CC BY-NC-SA | 浏览 | ||
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