Trends In Hospital Prices Paid By Private Health Plans Varied Substantially Across The US.
Trends In Hospital Prices Paid By Private Health Plans Varied Substantially Across The US.
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DOI：
10.1377/hlthaff.2021.01476
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发表时间：
2022-04
期刊：
影响因子：
9.7
通讯作者：
Whaley, Christopher M.
中科院分区：
文献类型：
--
作者：
Levinson, Zachary;Qureshi, Nabeel;Liu, Jodi L.;Whaley, Christopher M.
商业健康计划支付的价格高于医院护理的公共支付者，医院护理占美国国内生产总值的5%以上。制定有效的政策应对措施需要监测趋势和确定变化的来源。根据医疗保健提供者成本报告信息系统的数据，我们描述了2012-19年期间商业医院支付率相对于医疗保险费率的变化以及医院转诊区域（HRR）的趋势如何不同。我们发现，平均商业与医疗保险价格比相对稳定，但趋势在HRR之间差异很大。在2012年高价格比率的人力资源比率中，增长率最高的四分之一区域的比率增加了38个百分点，而最低的四分之一区域的比率则下降了38个百分点。我们的研究结果表明，在我们的样本期内，将HRR商业医院价格比率的增长率限制在全国平均水平，将使2019年的总支出减少390亿美元。
Commercial health plans pay higher prices than public payers for hospital care, which accounts for more than 5 percent of US gross domestic product. Crafting effective policy responses requires monitoring trends and identifying sources of variation. Relying on data from the Healthcare Provider Cost Reporting Information System, we describe how commercial hospital payment rates changed relative to Medicare rates during 2012–19 and how trends differed by hospital referral region (HRR). We found that average commercial-to-Medicare price ratios were relatively stable, but trends varied substantially across HRRs. Among HRRs with high price ratios in 2012, ratios increased by 38 percentage points in regions in the top quartile of growth and decreased by 38 percentage points in regions in the bottom quartile. Our findings suggest that restraining the growth rate of HRR commercial hospital price ratios to the national average during our sample period would have reduced aggregate spending by $39 billion in 2019.
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