Increasing Transparency: Employer Hospital Price Transparency Study

The Challenge

Large price discrepancies exist between what private health plans pay for hospital services and what Medicare pays as reported in the “Nationwide Evaluation of Healthcare Prices Paid by Private Health Plans: Findings from Round 3 of an Employer-Led Transparency Initiative” from the RAND corporation:

  • Comparing 2016-2018 data from self-insured employers, state-based all-payer claims databases and health plans in 49 states with Medicare reimbursement rates, the RAND Corporation determined that US hospitals were charging private insurers 247% what they charged Medicare. Click here to access Round 3 of the report.
  • Florida was the fifth highest state reported on with Florida hospital prices for private insurance averaging 326% of Medicare prices.
  • Inpatient prices in Florida were reported to be 316% of Medicare, and outpatient prices were reported to be 340% of Medicare.

“Employers say the proof of how much more they pay underscores the need for change”New York Times, September 2020

Our Solution

The Employer Hospital Price Transparency Study is an ongoing business coalition and employer-led initiative to measure and publicly report the prices paid for hospital care at the hospital and service-line levels.

  • The purpose is to enable employers to be better informed consumers when shopping for health plans and provider networks.
  • Insights from this project allow the Florida Alliance for Healthcare Value staff and employer members to assess whether their negotiated prices are reasonable and how effectively their insurance carriers negotiated with providers.

Recruitment and Contact

Recruitment for Round 4 is underway. If you would like to participate or receive more information about the Employer Hospital Price Transparency Study, please contact Ashley Tait-Dinger, MBA. Participation in this project is open to all self-funded employers. Being a member of the Florida Alliance is not required.