Hospital Data Reveals Significant Delta Between Commercial & Medicare Pricing

By Craig Gottwals – Attorney & RBP Expert

In looking at the 15 largest hospital systems in the U.S., the data reveals a persistent, significant delta between commercial and Medicare pricing, with the average commercial price hitting 282% of the Medicare rate.  This is not a slight variation; select systems are charging up to a massive 410% of what Medicare pays for equivalent services.  This pricing has profound financial consequences for large-group plans.

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