Gap in Public-Private Insurance Payments Contines to Widen

MedicalResearch.com Interview with:
Thomas Selden, Ph.D.

Director of the Division of Research and Modeling
Center for Financing, Access, and Cost Trends
Agency for Healthcare Research and Quality (AHRQ), in Rockville, Maryland. 

Medical Research: What is the background for this study? What are the main findings?

Dr. Selden: Spending on hospital care is expected to exceed $1 trillion for the first time in 2015, and it is important to understand the differences between public and private payment rates if we want to achieve the goals of better care, smarter spending, and healthier people – the triple aims found in HHS’ National Quality Strategy.  Our study examined data on inpatient hospital stays between 1996 and 2012, finding that payments to hospitals from private insurers in 2012 were 75 percent greater than Medicare’s – a sharp increase from the approximate 10 percent difference between 1996 and 2001. 

Medical Research: What should clinicians and patients take away from your report?

Dr. Selden: Our research focused on documenting differences in payment rates for inpatient care by type of insurance coverage.  The implications of these financing differences for clinicians and patients remain to be seen.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Selden: Our findings highlight the importance of further study in two key areas:

(a) what are the causes of this widening payment rate difference, and

(b) what, if any, are the consequences of payment differences for quality of care.

Citation:

The Growing Difference Between Public And Private Payment Rates For Inpatient Hospital Care

Thomas M. Selden, Zeynal Karaca, Patricia Keenan,Chapin White and Richard Kronick

Health Aff December 2015 34:122147-2150;doi:10.1377/hlthaff.2015.0706

Thomas Selden, Ph.D. (2015). Gap in Public-Private Insurance Payments Contines to Widen MedicalResearch.com

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