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Modern Healthcare: Private plans pay California hospitals more than double the Medicare rate

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May 20, 2019

by SHELBY LIVINGSTON 

May 20, 2019

Private insurers paid California hospitals more than two times as much as Medicare for similar services in 2015 and 2016, according to a study published Monday by West Health Policy Center.

The study found that private insurers paid hospitals an average 209% of Medicare, though there was wide variation across hospitals. Private insurers paid the costliest hospitals 364% of Medicare on average, while they paid the least expensive hospitals an average 89% of Medicare. The most expensive hospitals tended to be private not-for-profit hospitals, while the least costly were public hospitals.

The study comes on the heels of a report by RAND Corp. that found that private employer-sponsored health plans paid hospitals in 25 states 241% of Medicare prices on average in 2017. That study did not include California.

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