Dataset Information

The Relationship between Commercial Health Care Prices and Medicare Spending and Utilization.

ABSTRACT:

Objective

To explore the relationship between commercial health care prices and Medicare spending/utilization across U.S. regions.

Data sources

Claims from large employers and Medicare Parts A/B/D over 2007-2009.

Study design

We compared prices paid by commercial health plans to Medicare spending and utilization, adjusted for beneficiary health and the cost of care, across 301 hospital referral regions.

Principal findings

A 10 percent lower commercial price (around the average level) is associated with 3.0 percent higher Medicare spending per member per year, and 4.3 percent more specialist visits (p < .01).

Conclusions

Commercial health care prices are negatively associated with Medicare spending across regions. Providers may respond to low commercial prices by shifting service volume into Medicare. Further investigation is needed to establish causality.

SUBMITTER: Romley JA

PROVIDER: S-EPMC4450935 | biostudies-literature |

REPOSITORIES: biostudies-literature

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