10 states where private insurers pay the most, least relative to Medicare

Nationwide, private insurers pay an average of 247 percent more than what Medicare pays for similar services, according to a RAND Corp. study published Sept. 18. 

Advertisement

The study examined 750,000 claims for inpatient hospital stays and 40.2 million claims for outpatient services between 2016 and 2018. The sample included data from 3,112 hospitals across 49 states.

The Advisory Board mapped where private insurers pay hospitals the most and least relative to Medicare. Data for Hawaii, North Dakota, Maryland and South Dakota were unavailable. 

Here are the 10 states where private insurers pay the most relative to Medicare:

1. West Virginia: 349.2 percent 
2. South Carolina: 349.1 percent 
3. Florida: 340 percent
4. Tennessee: 329.5 percent 
5. Alaska: 327.5 percent 
6. Indiana: 304.1 percent 
7. Georgia: 299 percent 
8. Minnesota: 295.7 percent 
9. Wisconsin: 290.3 percent 
10. Virginia: 288.3 percent

Here are the 10 states where private insurers pay the least relative to Medicare:

1. Arkansas: 186.1 percent 
2. Michigan: 193.6 percent 
3. Rhode Island: 195.9 percent
4. Nevada: 207.9 percent
5. Pennsylvania: 208.8 percent
6. Kentucky: 214.2 percent
7. Connecticut: 214.6 percent
8. Utah: 216.1 percent 
9. Kansas: 225.9 percent 
10. Massachusetts: 227.7 percent 

More articles on healthcare finance:
8 health systems with strong finances
10 ACOs with the most shared savings in 2019
Chicago hospital defeats allegations of ‘ghost payroll’ scheme

At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.

Register to Attend Webinar

Reconsider What’s Possible: Enterprise RCM and the Pro-Fee Practice

Tuesday, July 28
11:00 AM - 12:00 PM CDT

Presenters: Garett Kreitz, Med-MetrixJohn Stefanowicz, Med-Metrix

Advertisement

Next Up in Financial Management

Advertisement

Comments are closed.