Employer-sponsored plans have little leverage to negotiate with providers: Study

Becker's Healthcare September 7, 2023
Rylee Wilson

Employers that self-fund their employees’ insurance pay moderately more for several medical services than fully funded plans, a study published in the September issue of Health Affairs found.

The study examined claims data from 2021 for enrollees in employer-sponsored plans administered by Aetna, Humana and more than 30 Blue Cross Blue Shield companies. The claims data showed plans fully funded by employers and administered by insurers paid more for some services.

On average, self-funded plans paid 8 percent more than fully insured plans for endoscopies, 7 percent more for colonoscopies and 5 percent more for complete blood-count testing. Self-paid plans also paid 4 percent more on average for emergency...

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