系统附属医院和非营利性医院推动了商业住院价格的增长。

Jessica Y Chang, Kathryn Martin
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摘要

随着政策制定者不断努力应对不断上涨的医疗成本和价格,了解不同医院特征的住院价格趋势和变化是政策制定者制定有针对性政策的重要基准。在本研究中,我们利用医疗成本研究所(Health Care Cost Institute)的雇主赞助投保理赔数据,对商业健康计划支付的住院病人价格变化趋势进行了描述性分析,并按医院特征进行了分层。我们的分析发现,住院病人价格水平之间存在相当大的差异,并且在系统关联性和盈利能力之间也存在增长。系统附属医院的价格从 2012 年的 14 281.74 美元增长到 2021 年的 20 731.95 美元,在此期间增长了 45.2%。另一方面,独立医院的价格增长较为缓慢,从 2012 年的 13 460.50 美元增至 2021 年的 18 196.90 美元,增幅为 35.2%。我们没有观察到按医院特征划分的病例组合指数增长率的类似趋势,这意味着住院病人价格增长的差异并不是由医院特征的病例组合变化驱动的。按医院类型划分的医院价格和价格增长的异质性表明,旨在控制医疗支出的公共和私人政策制定者应考虑针对这种差异的政策。
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Commercial inpatient hospital price growth driven by system affiliation and nonprofit-status hospitals.

As policymakers continue to grapple with rising health care costs and prices, understanding trends and variations in inpatient prices among hospital characteristics is an important benchmark to allow policymakers to craft targeted policies. In this study, we provide descriptive trends on variation in inpatient prices paid by commercial health plans stratified by hospital characteristics using data from Health Care Cost Institute's employer-sponsored insured claims data. Our analyses found evidence of considerable variation among inpatient price levels and growth among system affiliation and profitability. Prices among system-affiliated hospitals grew from $14 281.74 in 2012 to $20 731.95 in 2021, corresponding to a 45.2% increase during this period. On the other hand, prices among independent hospitals grew more slowly, from $13 460.50 in 2012 to $18 196.90 in 2021, corresponding to a 35.2% increase. We did not observe a similar trend in growth rates among case mix index by hospital characteristics, implying that differential inpatient price growth is not driven by changes in case mix by hospital characteristics. Heterogeneity in hospital prices and price growth by type of hospital suggests that public and private policymakers aiming to rein in health spending should consider policies that address this variation.

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