A Medicare Shared-Savings Program Snapshot

CIRCA: ACOs 2020

By http://www.MCOL.com



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  1. Private Insurers Paid 267% of Medicare Prices for Outpatient Services

    RAND Health Care recently released an analysis of prices paid by private health plans. Here are some key findings from the report:

    • In 2018, private insurers paid 247% of what Medicare would have paid for the same services/facilities.
    • Relative prices for hospital inpatient services averaged 231% of Medicare.
    • Private insurers paid an average of 267% of Medicare prices for hospital outpatient services.
    • Arkansas, Michigan, and Rhode Island had relative prices under 200% of Medicare.
    • Florida, Tennessee, Alaska, West Virginia, and South Carolina had prices above 325% of Medicare.

    Source: RAND Health Care, September 2020



    Privately insured patients pay 247% more at hospitals on average than Medicare patients for the same care, according to a new study by nonprofit think tank RAND Corporation.



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