The Relationship between Commercial Health Care Prices and Medicare Spending and Utilization.
Ontology highlight
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 | 2015 Jun
REPOSITORIES: biostudies-literature
Publications
The Relationship between Commercial Health Care Prices and Medicare Spending and Utilization.
Romley John A JA Axeen Sarah S Lakdawalla Darius N DN Chernew Michael E ME Bhattacharya Jay J Goldman Dana P DP
Health services research 20141127 3
<h4>Objective</h4>To explore the relationship between commercial health care prices and Medicare spending/utilization across U.S. regions.<h4>Data sources</h4>Claims from large employers and Medicare Parts A/B/D over 2007-2009.<h4>Study design</h4>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.<h4>Principal findings</h4>A 10 percent lower commercial price (around t ...[more]
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