Hospital Emergency Sign

“In Indiana, a local hospital system, Parkview Health, charged private insurance companies about four times what the federal Medicare program paid for the same care, according to a study of hospital prices in 25 states released on Thursday by the nonprofit RAND Corp.,” Reed Abelson writes over at The New York Times. “Colorado employers were shocked to learn they were paying nearly eight times what the federal government did for outpatient services like an emergency room visit, an X-ray or a checkup with a specialist at Colorado Plains Medical Center, northeast of Denver. Across the nation, hospitals treating patients with private health insurance were paid overall 2.4 times the Medicare rates in 2017, according to the RAND analysis. The difference was largest for outpatient care, where private prices were almost triple what Medicare would have paid. ‘It’s eye-opening, really, not just for the employers,’ said Gloria Sachdev, the chief executive of the Employers’ Forum of Indiana, a coalition that helped with the study. ‘It’s eye-opening for the hospitals.’ The RAND study underscores the widening chasm between what the federal government and the private sector pay the nation’s hospitals. The disparity shows how competition has faltered in an opaque market where the costs of care are secret and hospital systems are increasingly consolidated, gaining outsize clout in price negotiations with employers, some experts say.” Reed Abelson, “Many Hospitals Charge Double or Even Triple What Medicare Would Pay,” The New York Times.

Jeanne Pinder

Jeanne Pinder  is the founder and CEO of ClearHealthCosts. She worked at The New York Times for almost 25 years as a reporter, editor and human resources executive, then volunteered for a buyout and founded...