Large Self-insured Employers Lack Power to Effectively Negotiate Hospital Prices.
OBJECTIVES: Self-insured employers cover more people than Medicare, Medicaid, or direct purchasers of private insurance. This study examined the ability of self-insured employers to negotiate hospital prices and the relationship between hospital prices and employer market power in the United States....
| Publicado en: | American Journal of Managed Care Vol. 27; no. 7; pp. 290 - 306 |
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| Autores principales: | , , , , |
| Formato: | pictorial research tables/charts Journal Article |
| Publicado: |
MJH Life Sciences
Jul2021
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=151704728&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 151704728 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10880224 5QN jtl: American Journal of Managed Care issn: 10880224 maglogo: N pubinfo: dt: Jul2021 vid: 27 iid: 7 pid: 54670 pub: MJH Life Sciences place: Cranbury, New Jersey artinfo: ui: 151704728 151704728 151704728 10.37765/ajmc.2021.88702 151704728 ppf: 290 ppct: 16 formats: tig: atl: Large Self-insured Employers Lack Power to Effectively Negotiate Hospital Prices. aug: au: Eisenberg, Matthew D. Meiselbach, Mark K. Ge Bai Sen, Aditi P. Anderson, Gerard affil: Department of Health Policy and Management, Bloomberg School of Public Health sug: subj: Health Benefit Plans, Employee United States Health Care Costs Economics Negotiation Hospitals Human United States Cross Sectional Studies Census Health Insurance Exchanges Employer-Employee Relations Descriptive Statistics United States Centers for Medicare and Medicaid Services Collective Bargaining Funding Source ab: OBJECTIVES: Self-insured employers cover more people than Medicare, Medicaid, or direct purchasers of private insurance. This study examined the ability of self-insured employers to negotiate hospital prices and the relationship between hospital prices and employer market power in the United States. STUDY DESIGN: Repeated cross-section analysis of commercial claims. METHODS: We used the US Census Bureau County Business Patterns data to estimate employer market power at the metropolitan statistical area (MSA)--year level and used the Truven Health MarketScan commercial claims to estimate mean hospital prices and price ratios at the MSA-year level (2010-2016). We calculated descriptive statistics for employer market power, mean hospitalization prices, and a case mix--adjusted price ratio measure during the study period and analyzed the 10 most concentrated labor markets. We estimated MSA-year--level ordinary least squares regressions of hospitalization price and the price ratio measure on employer market power. RESULTS: Large self-insured employers had concentrated market power in very few MSAs in 2016. The mean value of our employer market power measure was 62 for 2016, compared with the mean value of 5410 for hospital market power in the United States. Regression analyses find a slight relationship: A 1-point increase in employer market power was associated with a $6.61 decrease in the hospitalization price (mean = $20,813), but this result becomes statistically insignificant once the models control for hospital wages. CONCLUSIONS: Employer market power is low in most MSAs. Self-insured employers may consider building purchase alliances with state and local government employee groups to enhance their market power and lower negotiated prices for hospital services. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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