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Employer Sponsored Health Insurance

In the United States and other countries that do not have national health systems, employers often offer health insurance as a benefit to employees. RAND has examined how employer-sponsored health insurance impacts economic and social factors such as entrepreneurs and small businesses, national-level health care costs, industry economic performance, and labor market conditions.

Research Brief

Private U.S. Health Plans Pay Hospitals 247 Percent of What Medicare Would Pay

RAND researchers used data from 49 states and Washington, D.C., to assess hospital prices paid by private health plans. Data sources included $33.8 billion in spending from 3,112 community hospitals—more than half of community hospitals nationwide.

Feb 24, 2021
News Release

Setting Hospital Prices Can Achieve Greater Savings Than Increasing Competition or Price Transparency

Among strategies to curb hospital prices among the commercially insured population in the United States, direct price regulations such as setting rates are likely to achieve greater savings than other approaches like increasing competition or improving price transparency.

Feb 18, 2021
Report

Setting U.S. Hospital Prices Could Cut Overall Health Spending by Billions

Price regulations face political obstacles and have been strongly opposed by medical providers. But setting prices for all commercial health care payers could reduce hospital spending by $61.9 billion to $236.6 billion a year if the rates were set at 100 to 150 percent of the amounts paid by Medicare.

Feb 18, 2021
News Release

Private Health Plans in the U.S. Pay Hospitals 247% of What Medicare Would Pay

Prices paid to hospitals nationally during 2018 by privately insured patients averaged 247% of what Medicare would have paid, with wide variation in prices among states.

Sep 18, 2020
Report

Private Health Plans Pay Hospitals 247% of What Medicare Would Pay

Employers are the largest source of U.S. health insurance, but a lack of price transparency makes it hard for them to assess the costs of hospital services. An analysis of hospital spending by private insurers finds that prices are on average almost two and a half times more than what Medicare would pay.

Sep 18, 2020
News Release

Private Health Plans Pay Hospitals 241% of What Medicare Would Pay

An examination of U.S. hospital prices covering 25 states shows that in 2017, the prices paid to hospitals for privately insured patients averaged 241% of what Medicare would have paid, with wide variation in prices among states.

May 9, 2019
Report

Private Health Plans Pay Hospitals Much More Than What Medicare Would Pay

An examination of U.S. hospital prices covering 25 states shows that in 2017, the prices paid to hospitals for privately insured patients averaged 241 percent of what Medicare would have paid. There was also wide variation in prices among states.

May 9, 2019
Journal Article

Association of Reference Pricing with Drug Selection and Spending

Over an 18 month period, reference pricing for drugs was associated with a reduction in employer spending of $1.34 million but an out-of-pocket spending increase of $0.12 million for employees.

Sep 28, 2017
News Release

Private Payments for Hospital Care in Indiana Are High Relative to Similar Payments Made by Medicare

The prices that large employers pay for hospital care in Indiana are high relative to national norms and are increasing over time relative to the prices that Medicare pays for the same services.

Sep 7, 2017
Report

Employers Pay More Than Medicare for Hospital Services in Indiana

Employers paid 3.5 times what Medicare would have paid for the same hospital outpatient services in Indiana — and 2.1 times the Medicare rate for inpatient care. Price transparency nationwide could help employers become better-informed purchasers of health care and stronger advocates for their employees.

Sep 7, 2017
Multimedia

Drama over Health Care Continues

In this Call with the Experts, RAND senior economist Christine Eibner discusses the Affordable Care Act, what policymakers should consider, and changes that the current administration could make.

Apr 11, 2017
Commentary

Can a Continuous Coverage Requirement Produce a Healthy Insurance Market?

A continuous coverage requirement aims to discourage individuals from waiting until they become sick to buy insurance. This works well in theory. But there is little evidence on how it might work in practice.

Jan 4, 2017
Journal Article

Adverse Selection in Retiree Prescription Drug Plans

Claims data from a large U.S. employer that introduced changes in its medical and drug coverage offerings in 2002 for non-Medicare eligible retirees.

Jun 28, 2016
Report

Private Health Insurance Exchanges: Early Evidence and Implications for the Future

To date, enrollment in the private health insurance exchanges is low, and there is not enough evidence to determine whether they will become prominent in the insurance market and how they will affect employers and their employees.

May 9, 2016
Research Brief

Advancing Complementary and Alternative Medicine Professions: Practitioners Face Many Policy Hurdles to Finding Their Place in Mainstream Medicine

The policy challenges associated with coverage, licensure, scope of practice, institutional privileges, and research may prevent complementary and alternative medicine professionals from practicing to the full extent of their capabilities.

Feb 8, 2016
Journal Article

Policy Options for Providing ACA Subsidies

The ACA provides tax subsidies to qualified individuals for purchasing insurance while retaining tax exemptions for contributions to employer-sponsored insurance premiums. There are several options for leveling the financial playing field between the two markets.

Dec 10, 2015
Commentary

Insurance Enrollment Holds Steady in Advance of the 2016 Open Enrollment Period

Since September 2013, the number of people with health insurance coverage has increased by 16.6 million. But since the second ACA open enrollment period in February 2015, the number of people with coverage has remained relatively flat. The third open enrollment period began on November 1. Whether the number of uninsured will continue to decline remains an open question.

Nov 12, 2015
Commentary

A Tale of Two Deliveries, or an Out-of-Network Problem

Two mothers gave birth within weeks of each other, at the same hospital, using the same employer-sponsored insurance. Both had an epidural. But one received a surprise physician bill for anesthesiology, while the other didn't have to pay a dime. Why?

Nov 4, 2015
Report

Can the Cadillac Tax Be Made Less Regressive by Replacing It with an Exclusion Cap? Methods and Results

Examines the effects of the Affordable Care Act's Cadillac tax versus an alternative tax, based on an exclusion gap, on families in different income ranges.

Oct 8, 2015
Report

Alternatives to the ACA's Affordability Firewall

This report examines policy impacts of the Affordable Care Act's "affordability firewall," which limits subsidies to individuals lacking access to alternative sources of coverage that are "affordable," and investigates two potential modifications.

Oct 5, 2015

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