Researchers examined Health Care Cost Institute claims data from 2007 to 2014 using price paid versus rates negotiated with clinicians.
What you should know:
1. For inpatient care, hospital prices grew 42 percent, while physician prices grew 18 percent.
2. For outpatient care, hospital prices grew 25 percent, while physician prices grew 6 percent.
3. Researchers also examined prices for common procedures involving outpatient colonoscopy and knee replacement.
For colonoscopy:
- Mean physician price: $628.37
- Mean hospital price: $1,791.04
For knee replacement:
- Mean physician price: $4,857.60
- Mean hospital price: $24,906.25
4. Hospital-based prices drove the most growth in payments.
Researchers concluded, “Our work suggests that efforts to reduce health care spending should be primarily focused on addressing growth in hospital rather than physician prices. Policy makers should consider a range of options to address hospital price growth, including antitrust enforcement, administered pricing, the use of reference pricing, and incentivizing referring physicians to make more cost-efficient referrals.”
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