Insurers Negotiate Lower Hospital Prices for HIX Than for Commercial Groups
Hospital price transparency data suggest that health insurance exchange (HIX) plans get lower negotiated rates than commercial group plans and higher negotiated rates than Medicare Advantage plans.
Commercial and Medicare Advantage Payment for Anesthesiology Services
Mean in-network commercial allowed amounts and charges per anesthesia conversion factor are 314% and 659% of traditional Medicare rates, respectively. Medicare Advantage payments align with traditional Medicare prices.
Policies to Address Surprise Billing Can Affect Health Insurance Premiums
In addition to protecting patients from receiving unexpected bills, policies to address surprise billing could reduce health insurance premiums by 1% to 5%.
Provider-Owned Insurers in the Individual Market
Provider-owned insurers sell individual policies in areas that cover 62% of the US population and have premiums similar to policies of traditional insurers.
Financial Burden of Healthcare Utilization in Consumer-Directed Health Plans
Enrollment in a consumer-directed health plan increases the financial burden associated with healthcare utilization, especially for those with lower incomes and with chronic conditions.
Provider-owned insurers have the potential to reduce costs, but face challenges building competitive provider networks.
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