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:

  • Comparing 2015-2017 data from self-insured employers, state-based all-payer claims databases and health plans in 25 states with Medicare reimbursement rates, the RAND Corporation determined that US hospitals were charging private insurers 2.4 times what they charged Medicare. Click here to access the full report.
  • Florida fell in the middle of the 25 states with Florida hospital prices for private insurance averaging 229% of Medicare prices.
  • Inpatient prices in Florida were reported to be 193% of Medicare, and outpatient prices were reported to be 302.5% of Medicare.

“The RAND analysis — encompassing hospitals in 25 states — is in some ways the most important analysis of hospital prices ever done…”Forbes, May 2019

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.

Contact

For more information about the Employer Hospital Price Transparency Study, please contact Ashley Tait-Dinger, MBA.