Relationships among cash prices, negotiated rates, and chargemaster
prices
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Thursday, April 20, 2023 | The Latest Research, Commentary, And News
From Health Affairs
Dear John,
Enjoying our daily newsletter? Consider joining Health Affairs Insider
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to receive curated newsletters written by health policy professionals
and experts on topics like social determinants, health reform, and more.
Prices For Shoppable Hospital Services
In accordance with the hospital price transparency rule, hospitals must
disclose their cash prices, commercial negotiated rates, and
chargemaster prices for seventy common, shoppable services.
In this month's issue, Yang Wang and colleagues examine prices publicly
reported by 2,379 hospitals
<[link removed]>
in September 2022.
The authors find that on average, for the same procedures at the same
hospital and in the same service setting, cash prices and commercial
negotiated rates are 64 percent and 58 percent of the corresponding
chargemaster prices.
In areas with stronger hospital market power or weaker insurer market
power, cash prices are more likely to be lower than negotiated rates.
Given that these findings suggest some self-insured employers pay prices
higher than cash prices, "employers may wish to consider using the
cash-price information as an input in their negotiations with insurers
or directly contracting with providers with low cash prices and steering
employees to them," the authors explain.
In addition to providing insight into the dynamics of hospital price
setting, Wang and colleagues' findings "underscore an ongoing concern
for policy makers interested in promoting hospital price transparency:
low compliance."
Read More
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Elsewhere At Health Affairs
Today in Forefront, Alexander Philips and coauthors propose mechanisms
for sustained advocacy
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opposing the use of Medicaid Section 1115 waivers to impose work
requirements and supporting their use of waivers to address social
determinants of health.
We also published a two-part article series on the Final 2024 Payment
Rule. In the first part, Sabrina Corlette writes about insurance market
rules and consumer assistance
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In the second piece, Matthew Fiedler writes about risk adjustment
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Read more on Forefront
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and learn more about how you can contribute
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to the publication.
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Daily Digest
The Relationships Among Cash Prices, Negotiated Rates, And Chargemaster
Prices For Shoppable Hospital Services
<[link removed]>
Yang Wang et al.
Medicaid Section 1115 Waivers: From Work Requirements To Social
Determinants Of Health
<[link removed]>
Alexander Philips et al.
Final 2024 Payment Rule, Part 1: Insurance Market Rules And Consumer
Assistance
<[link removed]>
Sabrina Corlette
Final 2024 Payment Rule, Part 2: Risk Adjustment
<[link removed]>
Matthew Fiedler
[link removed]
Test your health policy knowledge on the question below:
An estimated 1.3 million people who are are eligible for free or nearly
free cost-sharing reduction options through the ACA Marketplaces remain
uninsured. There are evidence-based methods that can improve Marketplace
enrollment. Which method below has demonstrated increased enrollment?
* TV commercials in districts where eligibles reside
* personalized letters and emails to those eligible
* pamphlets and brochures provided at hospitals
Answer <[link removed]>
Jobs At Health Affairs
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policy and health care.
Our team contains a deep bench of experienced professionals in health
policy, dedicated to making health care better. Below are the current
job openings at Health Affairs:
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About Health Affairs
Health Affairs is the leading peer-reviewed journal
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health care, and policy. Published monthly by Project HOPE, the journal
is available in print and online. Late-breaking content is also found
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health care workers to save lives across the globe. Project HOPE has
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