RAND: Average price for outpatient hospital care in Indiana 358% of Medicare rate

Large employers pay high prices for hospital care in Indiana compared to Medicare rates, according to a RAND Corp. study.

For the study, researchers examined insurance claims data to determine prices large, self-funded employer-sponsored health plans pay for hospital care in Indiana relative to Medicare payments for the same care. The examined claims represent services rendered from July 2013 through June 2016.

Here are five findings from the study.

1. The study revealed prices for hospital care in Indiana ranged from less than two times the Medicare rate to more than 3.5 times the Medicare rate among groups of hospitals and hospital systems.

2. For instance, Fort Wayne, Ind.-based Parkview Health had the highest prices at 3.7 times the Medicare rate, RAND said. Evansville, Ind.-based Deaconess Health System had prices at 1.2 times the Medicare rate.

3. Employers that participated in the study offer coverage to 225,000 Hoosiers. The study revealed prices these employers paid for hospital outpatient services averaged 358 percent of the Medicare rate.

4. RAND said the study found employers paid, on average, 2.17 times the Medicare rate for inpatient hospital care in Indiana.

5. Based on the findings, the report encourages employers in Indiana to "redesign their health plans to bring hospital prices more in line with national norms and to better align prices with the quality and value of the care provided." The report also encourages employers to "advocate for, or directly initiate, the creation and maintenance of a multipayer claims database, so that they can monitor trends in price levels and variation," among various other recommendations.  

Read more about the report findings here.

 

More articles on finance:

5 pieces of RCM advice for practices
11 latest hospital credit downgrades
10 hospitals seeking RCM talent

© Copyright ASC COMMUNICATIONS 2017. Interested in LINKING to or REPRINTING this content? View our policies by clicking here.

 

Top 40 Articles from the Past 6 Months