The study found private insurers on average pay more than 3.5 times what Medicare pays for anesthesia. The payment difference was linked to private insurance rates set through negotiations between providers. Medicare rates for anesthesia are set by CMS.
The GAO looked at studies from Yale University, the Health Care Cost Institute and the American Society of Anesthesiologists in their analysis.
A variety of market factors likely contributed to anesthesia providers’ negotiation position and allowed them to set higher rates, the study found. One example was high provider concentration, which means providers could negotiate higher rates due to little competition. Specialists, including anesthesia providers, could also negotiate higher in-network rates since they could leave a network with less risk of losing patients or revenue.
Read more details and access the full report here.
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