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But Also That It Varies from 150% to 400%.
BY ERIC BRICKER MD
Health Insurance Companies Paid for Hospital Outpatient Services at an Even Higher Average Rate of 293% of Medicare.
A Detailed Look at the RAND Analysis Reveals that the ‘Basket’ of Services at Each Hospital Had Very Little Data.
For Example, the RAND Study’s Data for the Baylor Scott & White Hospital System in Dallas – Fort Worth Represented Only 0.4% of the Hospital’s Total Revenue.
For the Texas Health Hospital System Also in Dallas – Fort Worth, the RAND Study’s Data Only Represented 0.96% of the Hospital’s Total Revenue.
That Sample Size Is Likely Too Small to Make Accurate Comparisons from One Hospital System to Another Regarding their Commercial Insurance Prices Relative to Medicare.
ASSESSMENT: Your thoughts and comments are appreciated.
THANK YOU
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Filed under: Ethics, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Insurance Matters, Managed Care, Quality Initiatives, Videos | Tagged: Commercial health insurance, Eric Bricker MD, hospital reimbursement, medicare, Part C, Rand |
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% of Out-of-Pocket Costs for Older U.S. Adults
• None: 15% ages 60-64, 19% ages 65+
• $1-$499: 14% ages 60-64, 32% ages 65+
• $500-$1,999: 30% ages 60-64, 23% ages 65+
• $2,000+: 36% ages 60-64, 20% ages 65+
Source: The Commonwealth Fund, Older Adults on Medicare and Those Near Medicare Age Face Cost Barriers to Care, November 2, 2021
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