News Release
Private Payments for Hospital Care in Indiana Are High Relative to Similar Payments Made by Medicare
Sep 7, 2017
Large employers sponsor health plans that enroll roughly half of the U.S. population, and they are in a strong position to demand increased value from the health care system. But large employers generally lack useful information about the prices they are paying for health care services. This report reveals the prices paid to hospitals in Indiana from 2013 through 2016 by large, self-funded employer-sponsored health plans.
Findings from an Employer-Led Transparency Initiative
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Large employers sponsor health plans that enroll roughly half of the U.S. population, and they are in a strong position to demand increased value from the health care system. But large employers generally lack useful information about the prices they are paying for health care services. This report reveals the prices paid to hospitals in Indiana from 2013 through 2016 by large, self-funded employer-sponsored health plans. Prices reflect the amounts paid per service, including amounts from both the health plan and the patient. To summarize hospital prices and make them easier to interpret, the report focuses on relative prices, using Medicare as a benchmark. The relative price equals the ratio of the price actually paid divided by the price that would have been paid — for the same services provided by the same hospital — using Medicare's price-setting formulas.
Chapter One
Background
Chapter Two
Data and Concepts
Chapter Three
Findings
Chapter Four
Discussion
The work was sponsored by the Robert Wood Johnson Foundation and was conducted by researchers from RAND Health in collaboration with the Employers' Forum of Indiana (EFI).
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