Prices vary within hospitals: Why patients should price shop payers | Becker’s Hospital Review

Research on price variation in healthcare often shows the stark differences patients pay for the same procedure at one hospital compared to another. However, a working paper published by the National Bureau of Economic Research suggests payers play an equally significant role in price variation, even within the same hospital.

For these five procedures, the researchers found prices within the same hospitals varied across payers by 16 to 28 percent. They found the most expensive payer was 13 percent more expensive than the least expensive payer on average. This means patients with high-deductible health plans could save an average $182 out of pocket by choosing the lower-priced payer over the higher-priced one. Self-insured employers stand to save even more — from $750 to $1,000 per enrollee, according to the report.

Variation across payers within hospitals is significant because it eliminates the variable of quality — the researchers assumed the quality of care was fairly consistent within a hospital. It also eliminates patient mix issues — patients who live near the same provider likely have similar risk profiles.

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Prices vary within hospitals: Why patients should price shop payers.