In markets with less payer competition, hospitals get lower reimbursements: Study

When payers control a large share of local markets, hospitals receive lower reimbursements for common services, a study published in the May issue of Health Affairs found. 

Researchers used price transparency data for 1,446 hospitals to compare payer rates for 14 common services. In states where the leading insurer had more than a 71 percent market share, hospitals received 14.7 percent less in average reimbursement rates than states where the largest payer had less than half the market. 

This trend was more pronounced at for-profit hospitals than their nonprofit counterparts, the study found. 

Further research is needed to determine if lowered payments to hospitals result in lower insurance premiums for consumers, the study's authors wrote. 

The study was written by researchers at Chicago-based DePaul University. Read the full study here. 

Copyright © 2023 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Whitepapers

Featured Webinars