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The High Price of Hospital Care

Dec 2019

The Center for American Progress has released a report examining the rising prices that patients are incurring from Hospitals across the country. Commercial insurers are estimated to pay about twice what Medicare does for hospital care. High prices do not always indicate better quality; in fact, they often mask inefficiencies in the hospital business. Among potential solutions to the growing industry-wide problem is to introduce reference-based pricing as a way to help negate the rising costs. Medxoom’s proprietary Comparison Shopping technology helps patients educate themselves on procedure price and quality variances before treatment with their health plan.

From Center for American Progress: ital profits and pricing variation across geographic areas and payers. The second portion describes policy options to rein in the high cost of hospital care. A summary of these recommendations are as follows:

  • End abusive hospital billing practices, including surprise billing and excessive charges
  • Implement reference pricing to incentivize patients and put pressure on providers
  • Implement rate regulation, setting or capping all payers’ rates closer to costs
  • Call for more public information on hospital pricing
  • Enforce more antitrust measures for the hospital industry
  • Impose site neutrality for payments

The variation in hospital prices across markets, across payers, and over time demonstrates that many Americans are paying more than needed for hospital care. The industry overall remains highly profitable and, after decades of rapid consolidation, exercises tremendous power over payers in many markets. The rise in hospital prices, in turn, continues to drive up premiums and cost-sharing for patients, hitting individuals who have commercial insurance the hardest.”

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