![]() "Hospitals have gotten increasingly powerful over time." "Where one large hospital dominates the markets, that hospital is able to get higher prices," he says. He says one major factor is the consolidation of hospitals, leading to a lack of competition. The data show that private-insurance payments vary widely and states that have low Medicare spending, like Minnesota, often have higher prices in the private insurance market. However, Medicare pays the same across the country. That analysis was based on Medicare data. "The market just isn't working," says Zack Cooper, a professor of health policy and economics at Yale University.Ĭooper says in the past, analysts believed that health care costs were rising because people were using too much health care. The price variations revealed by HCCI show that the health care market is not following traditional economic and market rules. It doesn't include claims information from The Blue Cross and Blue Shield Association, which is the largest health insurer in the country. It includes payment data from Aetna, Humana, UnitedHealthCare. The HCCI data is some of the most detailed and complete information available on health care prices paid by private insurance companies. "For every mile that a consumer drives south on I-95, they will save $100," Newman says. In Florida, the surgery costs $17,000 less in Miami than it does 180 miles north in Palm Bay. If a Sacramento knee replacement patient doesn't want to drive the 871 miles to Tucson, he or she could drive south to Riverside, Calif., and pay $27,000 less. It shows that states such as Minnesota and Wisconsin have higher than average prices while others, such as Florida and Maryland, were cheaper overall.Īrizona's health care prices were generally cheaper, about 82 percent of the national average, while next door in New Mexico, care was more expensive, about 25 percent above average. ![]() The reports compare average state prices for 242 medical services - from primary doctor visits to coronary angioplasty to a foot x-ray - to the national average price for those services. Newman is lead author of an article published Wednesday online in the journal Health Affairs that accompanied the release of the Chartbook. ![]() "There doesn't seem to be a systematic pattern with respect to what's high and what's low," says David Newman, HCCI's executive director. to analyze how prices for procedures vary from state to state, and city to city. The report, called the National Chartbook on Health Care Prices, uses claims and payment data from three of the largest insurance companies in the U.S. That's according to a report issued Wednesday by the Health Care Cost Institute. That's because the average price for a knee replacement in the Arizona city is $21,976, about $38,000 less than it would in Sacramento, Calif. Need knee replacement surgery? It may be worthwhile to head for Tucson. 20160427_atc_that_surgery_could_cost_you_thousands_less_a_few_states_over.mp3
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