Commercial-to-Medicare Price Ratios Remain Stable, Vary Across Regions

Commercial health plans pay much higher prices for hospital care than public payers, but just how much higher those prices are is far from uniform across the country. Between 2012 and 2019, average commercial-to-Medicare price ratios were relatively stable, with a 7% increase, but there were large increases in some hospital referral regions (HRRs) and reductions in others, according a study published in Health Affairs. Researchers suggested that restraining the growth rate of HRR commercial price ratios to the national average “would have reduced aggregate health care spending by $39 billion in 2019.”

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