How Much More Than Medicare Do Private Insurers Pay? A Review of the Literature
Eric Lopez, Tricia Neuman Follow @tricia_neuman on Twitter, Gretchen Jacobson, and Larry Levitt Follow @larry_levitt on Twitter
Published: Apr 15, 2020
Key Findings
- Private insurers paid nearly double Medicare rates for all hospital services (199% of Medicare rates, on average), ranging from 141% to 259% of Medicare rates across the reviewed studies.
- The difference between private and Medicare rates was greater for outpatient than inpatient hospital services, which averaged 264% and 189% of Medicare rates overall, respectively.
- For physician services, private insurance paid 143% of Medicare rates, on average, ranging from 118% to 179% of Medicare rates across studies.
