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Hospitals Charge Nonconventional Payers More Than Health Insurers, Study Finds

Healthcare Dive writes a new study in Health Affairs shows market power counts when it comes to negotiating hospital prices. Researchers from Johns Hopkins University compared pricing obtained by HMO/PPO insurers and other commercial payers, such as automobile and worker’s compensation insurance companies, at 153 Florida hospitals. Nonconventional insurers had far less negotiating power than their HMO/PPO counterparts. Between 2010 and 2016, the median price paid by HMO/PPO insurers rose from 1.9 times to 2.5 times the amount paid by Medicare. During the same period, the median price paid by other insurers grew from 2.8 times to 3.8 times the Medicare rate — more than 50% above the HMO/PPO price. The study offers further evidence that healthcare costs often have little to do with type or quality of care.

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