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Data: Whaley, et al., 2020, "Nationwide Evaluation of Health Care Prices Paid by Private Health Plans"; Cartogram: Andrew Witherspoon/Axios

Employers and private insurers paid hospitals, on average, 247% of what Medicare paid for the same services in 2018, per a new RAND study.

Why it matters: We all pay for this giant gap in prices through our premiums and lost wages.

The big picture: The price gap has been growing, with private insurers paying hospitals 224% of Medicare rates in 2016 and 230% in 2017. In 2018, prices were 267% of Medicare for outpatient services and 231% for inpatient services.

Between the lines: Prices varied drastically by location and by health system. Some states, including New York and Florida, paid more than 300% of Medicare rates, on average.

  • The most expensive system, John Muir Health, had prices that were 401.5% of Medicare. Sutter Health, which has settled a lawsuit brought by the state of California accusing the hospital system of price-gouging, was paid 326.6% of Medicare.
  • HCA Healthcare, one of the largest hospital systems, had prices that were 275.8% of Medicare. Community Health Network, another large health system that has continued to sue patients in coronavirus hotspots, was paid 260% of Medicare rates.

The other side: Hospitals have long argued that private insurance subsidizes inadequate government payment rate, and that they must charge privately insured patients more to make ends meet.

The bottom line: Hospitals make up the largest portion of overall health care spending. The pandemic may have momentarily distracted us from health care costs, but they're still high, and the pandemic's economic fallout has only made them more unaffordable for many Americans.

Go deeper

Dec 8, 2020 - Axios Events

Most employers didn't pay furloughed workers' health care premiums

Data: Bureau of Labor Statistics; Chart: Andrew Witherspoon/Axios

When the coronavirus forced businesses to tell their employees not to work, most kept paying at least some of those workers' wages — but not their health insurance premiums.

Why it matters: Millions of people have lost their income and their health care coverage at the same time during this pandemic, which could stick them with unaffordable medical bills or cause them to put off care they need.

OIG: HHS misused millions of dollars intended for public health threats

Vaccine vials. Photo: Punit Paranjpe/AFP via Getty Images

The U.S. Office of Special Counsel alerted the White House and Congress on Wednesday of an investigation that found the Department of Health and Human Services misused millions of dollars that were budgeted for vaccine research and public health emergencies for Ebola, Zika and now the COVID-19 pandemic.

Why it matters: The more than 200-page investigation corroborated claims from a whistleblower, showing the agency's violation of the Purpose Statute spanned both the Obama and Trump administrations and paid for unrelated projects like salaries, news subscriptions and the removal of office furniture.

John Kerry: U.S.-China climate cooperation is a "critical standalone issue"

President Biden's special climate envoy John Kerry said Wednesday that the U.S. must deal with China on climate change as a "critical standalone issue," but stressed that confronting Beijing's human rights and trade abuses "will never be traded" for climate cooperation.

Why it matters: The last few years have brought about a bipartisan consensus on the threat posed by China. But as the world's largest greenhouse gas emitter, China will be a vital player if the world is going to come close to reining in emissions on the scale needed to meet the Paris Agreement goals of limiting warming to 2°C above pre-industrial levels.