HealthLeaders Media August 10, 2023
New findings reflect the differences in negotiating dynamics and financial incentives in the two markets.
KEY TAKEAWAYS
– Authors of a study published in Health Affairs investigated 2022 price information disclosed by hospitals to compare commercial health plan versus Medicare Advantage (MA) health plan pricing negotiated by the same payer.
– The median hospital prices for commercial plans were two to three times higher than MA prices in the same hospital for the same service.
– Insurers willingly negotiate such higher prices for their commercial plans because of increased bargaining leverage afforded by MA dynamics, while the commercial market is largely self-funded by employers.
Hospital prices for commercial health plans are, on average, two to three times higher than Medicare...
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