Becker's Healthcare July 8, 2020
On average, private health insurers’ payment rates are between 1.6 and 2.5 times higher than Medicare, according to a data brief from the Kaiser Family Foundation.
The brief examines hospital payments from private payers and Medicare for 10 inpatient services. Data is from the IBM MarketScan Commercial Claims and Encounters Database and public Medicare payment and utilization data for 2014-17. For each service, KFF compared average payments made by private health plans and Medicare.
Here is how payment rates differed between private payers and Medicare for 10 inpatient services. The dollar amounts are averages in 2017.
Respiratory diagnoses related to COVID-19*
Respiratory with a ventilator for more than 96 hours (DRG 207)
Private payers: $100,461
Medicare: $40,218
Respiratory with a ventilator...
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