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Morning Briefing

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Friday, Sep 18 2020

Full Issue

Private Insurers Pay More Than Double What Medicare Pays For Same Care

“The prices are so high, the prices are so unaffordable — it’s just a runaway train,” said Gloria Sachdev, the chief executive of the Employers’ Forum of Indiana, a coalition that worked with RAND on the study.

Hospitals across the country are charging private insurance companies 2.5 times what they get from Medicare for the same care, according to a new RAND Corporation study of hospital prices released on Friday. In a half-dozen of 49 states in the survey, including West Virginia and Florida, private insurers paid three or more times what Medicare did for overnight inpatient stays and outpatient care. (Abelson, 9/18)

A new study suggests that hospitals' market power may have a bigger influence on prices than oft-touted factors like compensating for Medicare and Medicaid losses and providing high-quality care. It's the third and largest iteration of not-for-profit think tank RAND Corp.'s deep dive into how much private insurers pay for inpatient and outpatient hospital services. It found private insurers paid hospitals on average 247% what Medicare would have for the same services in 2018, a gap that's creeped up in recent years and varies widely across states. (Bannow, 9/18)

Read the Rand Corp. study:

In other Medicare updates —

About 1 in 3 people 65 and older in the U.S. enroll in Medicare Advantage, the private insurance alternative to traditional Medicare. It’s not hard to see why: Medicare Advantage plans often cover stuff that Medicare doesn’t, and most people don’t pay extra for it. But Medicare Advantage can be more expensive if you get sick because copays and other costs can be higher, says Katy Votava, president of Goodcare.com, a health care consultant for financial advisors and consumers. (Weston, 9/17)

You’ve already done the legwork. You know you’re eligible for Medicare and you already know which Medicare plan to enroll in based on your needs after examining and comparing all the available Medicare health insurance options.But now you’re faced with a bigger task — going through the complex process of Medicare enrollment. (9/17)

Also —

Older Americans already struggling financially amid the COVID-19 pandemic probably won’t find much solace in their Social Security checks next year. The 68 million people – including retirees, as well as disabled people and others – who rely on Social Security are likely to receive a 1.3% cost-of-living adjustment next year because of paltry inflation, according to an estimate by the Senior Citizens League, an advocacy group. For the average retiree who got a check of $1,517 this year, that would mean an additional $19.70 a month. (Davidson, 9/15)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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