May 10, 2019

Hospital costs are high and all over the place

Caitlin Owens, author of Vitals
Expand chart
Data: Rand Corporation; Chart: Lazaro Gamio/Axios

Private insurance plans pay hospitals, on average, 241% of what Medicare pays for the same services — and those rates vary widely from hospital to hospital, according to a new report by the RAND Corporation.

Why it matters: Hospitals make up the largest portion of health care spending, and even people who don't use hospital services pay for them through their premiums.

The big picture: This report reinforces that private insurance generally pays a lot more than Medicare, but it also is the first broad-based study to compare individual hospitals by name — giving it some practical utility for employers and insurers, which is often hard to come by because of the industry's secrecy.

Details: The study includes 1,600 hospitals in 25 states, covering $13 billion in payments from 2015 to 2017.

  • If hospitals had been paid Medicare rates over this period, the employers included in this study would have saved $7.7 billion.
  • Prices ranged from 150% of Medicare to more than 400%, depending on the hospital system. There was also significant variation among states.
  • Outpatient service rates were, on average, 293% of Medicare, while the average inpatient price was 204%.

Yes, but: Hospitals argue that they lose money on Medicare patients because the reimbursement rate is too low, so they have to charge private enrollees more to make up the difference.

The bottom line: Health care costs are only going to rise for those with private insurance. This study suggests that while tackling hospital rates may not be easy, it's an area that's ripe for reform, if employers — or policymakers — decide that they've had enough.

Go deeper: Employers' health care crisis will only get worse

Go deeper

Updated 16 mins ago - Politics & Policy

Amnesty International: U.S. police must end militarized response to protests

Washington State Police use tear gas to disperse a crowd in Seattle during a demonstration protesting the death of George Floyd. Photo: Jason Redmond/AFP via Getty Images

Amnesty International issued a statement on Sunday morning calling for an end to militarized policing in several U.S. cities and the use of "excessive force" against demonstrators protesting police brutality.

Why it matters: The human rights group said police across the country were "failing their obligations under international law to respect and facilitate the right to peaceful protest, exacerbating a tense situation and endangering the lives of protesters."

38 mins ago - Health

Coronavirus looms over George Floyd protests across the country

Protestors rally in Minneapolis. Photo: Tayfun Coskun/Anadolu Agency via Getty Images

Health experts fear that massive protests against police brutality in major cities around the United States could result in new coronavirus outbreaks due to the close proximity of demonstrators, AP reports.

Why it matters: The U.S. has already recorded more confirmed coronavirus cases and deaths than any other country in the world. A potential surge in cases stemming from the protests would come as many states are weeks into their phased reopening plans.

The cracks in Trump’s GOP shield

Photo Illustration: Sarah Grillo/Axios. Photo: Doug Mills-Pool/Getty Images

President Trump’s mockery of coronavirus masks, his false claims about the dangers of voting by mail and his insinuations that a cable TV nemesis was involved in a murder are testing more high-profile Republicans' willingness to look the other way.

The big picture: Republicans learned a long time ago how dangerous it is to alienate Trump’s base — which is why any hint of disagreement, even a whisper, is so remarkable when it happens.