Prices Paid to Hospitals by Private Health Plans: Findings from Round 5.1 of an Employer-Led Transparency Initiative.

Rand health quarterly Pub Date : 2025-03-17 eCollection Date: 2025-03-01
Christopher M Whaley, Rose Kerber, Daniel Wang, Aaron Kofner, Brian Briscombe
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Abstract

Because employer-sponsored spending comes from employee wages and benefits, employers have a fiduciary responsibility to administer benefits in the interest of participants. The lack of transparency of prices in the health care market limits employers' ability to knowledgeably develop or implement benefit design decisions. This study uses 2020-2022 medical claims data from a large population of privately insured individuals, including hospitals and other facilities from across the United States, to allow an easy comparison of hospital prices. An important innovation of this study is that hospitals and hospital systems (hospitals under joint ownership) are identified by name, which is usually not allowed under data use agreements.

私人医疗计划支付给医院的价格:雇主主导的透明度倡议5.1轮调查结果。
由于雇主赞助的支出来自雇员的工资和福利,雇主有受托责任为参与者的利益管理福利。医疗保健市场价格缺乏透明度限制了雇主明智地制定或实施福利设计决策的能力。本研究使用了来自大量私人保险个人(包括美国各地的医院和其他设施)的2020-2022年医疗索赔数据,以便轻松比较医院价格。本研究的一个重要创新是医院和医院系统(共同所有的医院)通过名称进行识别,这在数据使用协议中通常是不允许的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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