How Much More Than Medicare Do Private Insurers Pay? A Review of the Literature
Issue Brief
Centers for Medicare and Medicaid Services. 2019. National Health Expenditures 2018 Highlights. Washington, D.C.: Centers for Medicare and Medicaid Services. https://www.cms.gov/files/document/highlights.pdf
Tolbert, Jennifer, et. al. 2019. Key Facts about the Uninsured Population. Washington, D.C.: Kaiser Family Foundation. http://files.kff.org/attachment/Issue-Brief-Key-Facts-about-the-Uninsured-Population
Neuman, Tricia, et. al. 2019. Where Do the Democratic Candidates Stand on Health Reform? Washington, D.C.: Kaiser Family Foundation. https://www.kff.org/slideshow/where-do-the-democratic-candidates-stand-on-health-reform/
Kaiser Family Foundation. 2018. Medicare-for-All and Public Plan Buy-In Proposals: Overview and Key Issues. Washington, D.C.: Kaiser Family Foundation. https://www.kff.org/report-section/medicare-for-all-and-public-plan-buy-in-proposals-overview-and-key-issues-issue-brief/
“Medicare for All Act of 2019”. H.R. 1384, 116th Congress. 2019. https://www.congress.gov/bill/116th-congress/house-bill/1384
“Medicare for All Act of 2019”. S. 1129, 116th Congress. 2019. https://www.congress.gov/bill/116th-congress/senate-bill/1129/text
Song, Zirui 2019. “The Pricing of Care Under Medicare for All: Implications and Policy Choices”. JAMA. 322(5): 395-396. https://jamanetwork.com/journals/jama/fullarticle/2737591
Sanders, Bernard. 2017. “An Agenda to Fight Inequality”. The Lancet. 389(10077): P1376-1377. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30882-6/fulltext
Koller, Christopher and Khullar, Dhruv. 2019. “The Commercial Differential for Hospital Prices: Responses from States and Employers”. JAMA. Published online July 22, 2019. E1-E2. https://jamanetwork.com/journals/jama/article-abstract/2739290
Crowley, Ryan et. al.; Health and Public Policy Committee of the American College of Physicians. 2020. “Envisioning a Better U.S. Health Care System for All: Coverage and Cost of Care”. Annals of Internal Medicine. 172(2 Suppl.): S7-S32. https://annals.org/aim/fullarticle/2759529/envisioning-better-u-s-health-care-system-all-coverage-cost
“Increasing the Availability of Quality, Affordable Health Coverage in the Individual Market”. S.B. 5526, 66th Washington State Legislature, 2019. https://app.leg.wa.gov/billsummary?BillNumber=5526&Year=2019&Initiative=false
“Coronavirus Aid, Relief, and Economic Security Act”. S. 3548, 116th Congress. 2020. https://www.congress.gov/bill/116th-congress/senate-bill/3548/text
Strata Decision Technology. 2020. Hospitals Face Massive Losses on COVID-19 Cases Even With Proposed Increase in Federal Reimbursement. Chicago, IL: Strata Decision Technology. https://www.stratadecision.com/blog/report-hospitals-face-massive-losses-on-covid-19-cases-even-with-proposed-increase-in-federal-reimbursement/
Centers for Medicare and Medicaid Services. 2019. National Health Expenditures 2018 Highlights. Washington, D.C.: Centers for Medicare and Medicaid Services. https://www.cms.gov/files/document/highlights.pdf
Medicare Payment Advisory Commission. 2019. Hospital Acute Inpatient Services Payment System. Washington, D.C.: Medicare Payment Advisory Commission. http://medpac.gov/docs/default-source/payment-basics/medpac_payment_basics_19_hospital_final_v2_sec.pdf?sfvrsn=0
Centers for Medicare and Medicaid Services Office of the Actuary. 2019. Simulations of Affordable Care Act Medicare Payment Update Provisions on Part A Provider Financial Margins. Baltimore, MD: Centers for Medicare and Medicaid Services Office of the Actuary. https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/ReportsTrustFunds/Downloads/ACAmarginsimulations2019.pdf
Holahan, John and McMorrow, Stacey. 2019. Slow Growth in Medicare and Medicaid Spending per Enrollee Has Implications for Policy Debates. Washington, D.C.: Urban Institute. https://www.urban.org/research/publication/slow-growth-medicare-and-medicaid-spending-enrollee-has-implications-policy-debates
Cubanski, Juliette et. al. 2019. The Facts on Medicare Spending and Financing. Washington, D.C.: Kaiser Family Foundation. https://www.kff.org/medicare/issue-brief/the-facts-on-medicare-spending-and-financing/
“Increasing the Availability of Quality, Affordable Health Coverage in the Individual Market”. S.B. 5526, 66th Washington State Legislature, 2019. https://app.leg.wa.gov/billsummary?BillNumber=5526&Year=2019&Initiative=false
Colorado Department of Regulatory Agencies Division of Insurance, Colorado Department of Health Care Policy and Financing. 2019. Draft Report for Colorado’s State Coverage Option. Denver, Colorado: Department of Regulatory Agencies and Department of Health Care Policy and Financing. https://www.colorado.gov/pacific/dora/proposal-state-option-health-care-coverage
Crowley, Ryan et. al.; Health and Public Policy Committee of the American College of Physicians. 2020. “Envisioning a Better U.S. Health Care System for All: Coverage and Cost of Care”. Annals of Internal Medicine. 172(2 Suppl.): S7-S32. https://annals.org/aim/fullarticle/2759529/envisioning-better-u-s-health-care-system-all-coverage-cost
The Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds. 2011. 2011 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds. Washington, D.C.: Centers for Medicare and Medicaid Services. https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/ReportsTrustFunds/downloads/tr2011.pdf
Dobson, Allen, et. al. 2016. Estimating the Impact of Repealing the Affordable Care Act on Hospitals. Vienna, Virginia: Dobson DaVanzo & Associates, LLC. https://www.dobsondavanzo.com/clientuploads/Publications/Health_Care_Reform/FAH_&_AHA_
Impact_of_Repealing_the_ACA_on_Hospitals_Report_Attachment_11_30_16.pdfClemens, Jeffrey and Veuger, Stan. 2015. “Repeal of the Medicare Sustainable Growth Rate: Direct and Indirect Consequences”. AMA J. Ethics. 17(11): 1053-1058. https://journalofethics.ama-assn.org/article/repeal-medicare-sustainable-growth-rate-direct-and-indirect-consequences/2015-11
Goldsmith, Jeff et. al. 2019. “Medicare Expansion: A Preliminary Analysis of Hospital Financial Impacts”. Navigant Consulting, Inc. https://www.navigant.com/-/media/www/site/insights/healthcare/2019/medicare-expansion-analysis.pdf
Reed, Abelson. 2019. “Hospitals Stand to Lose Billions Under ‘Medicare for All’”. The New York Times. April 21, 2019. https://www.nytimes.com/2019/04/21/health/medicare-for-all-hospitals.html
Cooper, Zack et. al. 2018. “The Price Ain’t Right? Hospital Prices and Health Spending on the Privately Insured”. National Bureau of Economic Research, Working Paper 21815. Cambridge, MA: National Bureau of Economic Research. https://www.nber.org/papers/w21815
Kronick, Richard and Neyaz, Sarah. 2019. Private Insurance Payments to California Hospitals Average More Than Double Medicare Payments. Washington, D.C.: West Health Policy Center. https://assets-global.website-files.com/5c65bc6ef2c54007f2d69d05/5ce21ad67e30fb151b1f4caa_West%20Health%20Policy%20Center
%20Hospital%20Pricing%20Analysis%20May%202019.pdfGinsburg, Paul. 2010. “Wide Variation in Hospital and Physician Payment Rates Evidence of Provider Market Power”. Center for Studying Health Systems Change, Research Brief No. 16. http://www.hschange.org/CONTENT/1162/#ib2
White et. al. 2014. “Understanding Differences Between High- and Low-Price Hospitals: Implications for Efforts to Rein in Costs”. Health Affairs. 33(2): 324-331. https://www.healthaffairs.org/doi/10.1377/hlthaff.2013.0747
Ge, Bai and Anderson, Gerard. 2018. “Market Power: Price Variation Among Commercial Insurers for Hospital Services”. Health Affairs. 37(10): 1615-1622. https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2018.0567
White, Chapin 2017. “Hospital Prices in Indiana: Findings from an Employer-Led Transparency Initiative”. Santa Monica, CA: RAND Corporation. https://www.rand.org/pubs/research_reports/RR2106.html
White, Chapin and Whaley, Christopher. 2019. “Prices Paid to Hospitals by Private Health Plans Are High Relative to Medicare and Vary Widely”. Santa Monica, CA: RAND Corporation. https://www.rand.org/pubs/research_reports/RR3033.html
White, Chapin 2017. “Hospital Prices in Indiana: Findings from an Employer-Led Transparency Initiative”. Santa Monica, CA: RAND Corporation. https://www.rand.org/pubs/research_reports/RR2106.html
Ginsburg, Paul. 2010. “Wide Variation in Hospital and Physician Payment Rates Evidence of Provider Market Power”. Center for Studying Health Systems Change, Research Brief No. 16. http://www.hschange.org/CONTENT/1162/#ib2
White, Chapin et. al. 2013. “High and Varying Prices for Privately Insured Patients Underscore Hospital Market Power”. Center for Studying Health Systems Change, Research Brief No. 27. http://www.hschange.org/CONTENT/1375/1375.pdf
White, Chapin and Whaley, Christopher. 2019. “Prices Paid to Hospitals by Private Health Plans Are High Relative to Medicare and Vary Widely”. Santa Monica, CA: RAND Corporation. https://www.rand.org/pubs/research_reports/RR3033.html
Ge, Bai and Anderson, Gerard. 2018. “Market Power: Price Variation Among Commercial Insurers for Hospital Services”. Health Affairs. 37(10): 1615-1622. https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2018.0567
American Hospital Association. 2018. Trendwatch Chartbook 2018: Trends Affecting Hospitals and Health Systems. https://www.aha.org/guidesreports/2018-05-22-trendwatch-chartbook-2018
Maeda, Jared and Nelson, Lyle. 2017. “An Analysis of Private Sector Prices for Hospital Admissions”. Washington, D.C.: Congressional Budget Office, Working Paper 2017-02. https://www.cbo.gov/system/files/115th-congress-2017-2018/workingpaper/52567-hospitalprices.pdf
Baker, Laurence et. al. 2016. “Medicare Advantage Plans Pay Less Than Traditional Medicare Pays”. Health Affairs. 35(8): 1444-1451. https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2015.1553
Cooper, Zack et. al. 2018. “The Price Ain’t Right? Hospital Prices and Health Spending on the Privately Insured”. National Bureau of Economic Research, Working Paper 21815. Cambridge, MA: National Bureau of Economic Research. https://www.nber.org/papers/w21815
Wallace, Jacob and Song, Zirui 2016. “Traditional Medical Versus Private Insurance: How Spending, Volume, and Price Change at Age Sixty-Five”. Health Affairs. 35(5): 864-872. https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2015.1195
Wallace, Jacob and Song, Zirui 2016. “Traditional Medical Versus Private Insurance: How Spending, Volume, and Price Change at Age Sixty-Five”. Health Affairs. 35(5): 864-872. https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2015.1195
Medicare Payment Advisory Commission. March 2019. Report to the Congress: Medicare Payment Policy. Washington, D.C.: Medicare Payment Advisory Commission. http://www.medpac.gov/-documents-/reports
Medicare Payment Advisory Commission. 2019. Hospital Acute Inpatient Services Payment System. Washington, D.C.: Medicare Payment Advisory Commission. http://medpac.gov/docs/default-source/payment-basics/medpac_payment_basics_19_hospital_final_v2_sec.pdf?sfvrsn=0
Medicare Payment Advisory Commission. 2019. Outpatient Hospital Services Payment System. Washington, D.C.: Medicare Payment Advisory Commission. http://medpac.gov/docs/default-source/payment-basics/medpac_payment_basics_19_opd_final_sec.pdf?sfvrsn=0
Baker, Laurence et. al. 2016. “Medicare Advantage Plans Pay Less Than Traditional Medicare Pays”. Health Affairs. 35(8): 1444-1451. https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2015.1553
Kronick, Richard and Neyaz, Sarah. 2019. Private Insurance Payments to California Hospitals Average More Than Double Medicare Payments. Washington, D.C.: West Health Policy Center. https://assets-global.website-files.com/5c65bc6ef2c54007f2d69d05/5ce21ad67e30fb151b1f4caa_West%20Health%20Policy%20Center
%20Hospital%20Pricing%20Analysis%20May%202019.pdfMaeda, Jared and Nelson, Lyle. 2017. “An Analysis of Private Sector Prices for Hospital Admissions”. Washington, D.C.: Congressional Budget Office, Working Paper 2017-02. https://www.cbo.gov/system/files/115th-congress-2017-2018/workingpaper/52567-hospitalprices.pdf
White, Chapin et. al. 2013. “High and Varying Prices for Privately Insured Patients Underscore Hospital Market Power”. Center for Studying Health Systems Change, Research Brief No. 27. http://www.hschange.org/CONTENT/1375/1375.pdf
White, Chapin 2017. “Hospital Prices in Indiana: Findings from an Employer-Led Transparency Initiative”. Santa Monica, CA: RAND Corporation. https://www.rand.org/pubs/research_reports/RR2106.html
White, Chapin and Whaley, Christopher. 2019. “Prices Paid to Hospitals by Private Health Plans Are High Relative to Medicare and Vary Widely”. Santa Monica, CA: RAND Corporation. https://www.rand.org/pubs/research_reports/RR3033.html
American Hospital Association. 2018. Trendwatch Chartbook 2018: Trends Affecting Hospitals and Health Systems. https://www.aha.org/guidesreports/2018-05-22-trendwatch-chartbook-2018
Selden, Thomas, et. al. 2015. “The Growing Difference Between Public and Private Payments for Inpatient Hospital Care”. Health Affairs. 34(12): 2147-2150. https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2015.0706
Selden, Thomas, et. al. 2015. “The Growing Difference Between Public and Private Payments for Inpatient Hospital Care”. Health Affairs. 34(12): 2147-2150. https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2015.0706
Selden, Thomas. 2020. “Differences Between Public And Private Hospital Payment Rates Narrowed, 2012–16”. Health Affairs. 39(1): 94-99. https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2019.00415
Trish, Erin et. al. 2017. “Physician Reimbursement in Medicare Advantage Compared with Traditional Medicare and Commercial Health Insurance”. JAMA Internal Medicine. 177(9): 1287-1295. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2643349
Pelech, Daria. 2018. “An Analysis of Private Sector Prices for Physicians’ Services”. Washington, D.C.: Congressional Budget Office, Working Paper 2018-01. https://www.cbo.gov/system/files/115th-congress-2017-2018/workingpaper/53441-workingpaper.pdf
Song, Zirui 2019. “The Pricing of Care Under Medicare for All: Implications and Policy Choices”. JAMA. 322(5): 395-396. https://jamanetwork.com/journals/jama/fullarticle/2737591
White, Chapin and Whaley, Christopher. 2019. “Prices Paid to Hospitals by Private Health Plans Are High Relative to Medicare and Vary Widely”. Santa Monica, CA: RAND Corporation. https://www.rand.org/pubs/research_reports/RR3033.html
Ginsburg, Paul. 2010. “Wide Variation in Hospital and Physician Payment Rates Evidence of Provider Market Power”. Center for Studying Health Systems Change, Research Brief No. 16. http://www.hschange.org/CONTENT/1162/#ib2
Pelech, Daria. 2018. “An Analysis of Private Sector Prices for Physicians’ Services”. Washington, D.C.: Congressional Budget Office, Working Paper 2018-01. https://www.cbo.gov/system/files/115th-congress-2017-2018/workingpaper/53441-workingpaper.pdf
Pelech, Daria. 2018. “An Analysis of Private Sector Prices for Physicians’ Services”. Washington, D.C.: Congressional Budget Office, Working Paper 2018-01. https://www.cbo.gov/system/files/115th-congress-2017-2018/workingpaper/53441-workingpaper.pdf
Biener, Adam and Selden, Thomas. 2017. “Public and Private Payments for Physician Office Visits”. Health Affairs. 36(12): 2160-2164. https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2017.0749
Trish, Erin et. al. 2017. “Physician Reimbursement in Medicare Advantage Compared with Traditional Medicare and Commercial Health Insurance”. JAMA Internal Medicine. 177(9): 1287-1295. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2643349
Medicare Payment Advisory Commission. March 2018. Report to the Congress: Medicare Payment Policy. Washington, D.C.: Medicare Payment Advisory Commission. http://www.medpac.gov/-documents-/reports
Biener, Adam and Selden, Thomas. 2017. “Public and Private Payments for Physician Office Visits”. Health Affairs. 36(12): 2160-2164. https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2017.0749
Medicare Payment Advisory Commission. March 2019. Report to the Congress: Medicare Payment Policy. Washington, D.C.: Medicare Payment Advisory Commission. http://www.medpac.gov/-documents-/reports
Song, Zirui 2019. “The Pricing of Care Under Medicare for All: Implications and Policy Choices”. JAMA. 322(5): 395-396. https://jamanetwork.com/journals/jama/fullarticle/2737591
Medicare Payment Advisory Commission. 2019. Physician and Other Health Professional Payment System. Washington, D.C.: Medicare Payment Advisory Commission. http://medpac.gov/docs/default-source/payment-basics/medpac_payment_basics_19_physician_final_sec.pdf?sfvrsn=0
Trish, Erin et. al. 2017. “Physician Reimbursement in Medicare Advantage Compared with Traditional Medicare and Commercial Health Insurance”. JAMA Internal Medicine. 177(9): 1287-1295. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2643349
Medicare Payment Advisory Commission. March 2019. Report to the Congress: Medicare Payment Policy. Washington, D.C.: Medicare Payment Advisory Commission. http://www.medpac.gov/-documents-/reports
Pelech, Daria. 2018. “An Analysis of Private Sector Prices for Physicians’ Services”. Washington, D.C.: Congressional Budget Office, Working Paper 2018-01. https://www.cbo.gov/system/files/115th-congress-2017-2018/workingpaper/53441-workingpaper.pdf
White, Chapin et. al. 2013. “High and Varying Prices for Privately Insured Patients Underscore Hospital Market Power”. Center for Studying Health Systems Change, Research Brief No. 27. http://www.hschange.org/CONTENT/1375/1375.pdf
Wallace, Jacob and Song, Zirui 2016. “Traditional Medical Versus Private Insurance: How Spending, Volume, and Price Change at Age Sixty-Five”. Health Affairs. 35(5): 864-872. https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2015.1195
Pelech, Daria. 2018. “An Analysis of Private Sector Prices for Physicians’ Services”. Washington, D.C.: Congressional Budget Office, Working Paper 2018-01. https://www.cbo.gov/system/files/115th-congress-2017-2018/workingpaper/53441-workingpaper.pdf
Ginsburg, Paul. 2010. “Wide Variation in Hospital and Physician Payment Rates Evidence of Provider Market Power”. Center for Studying Health Systems Change, Research Brief No. 16. http://www.hschange.org/CONTENT/1162/#ib2
Song, Zirui 2019. “The Pricing of Care Under Medicare for All: Implications and Policy Choices”. JAMA. 322(5): 395-396. https://jamanetwork.com/journals/jama/fullarticle/2737591
Medicare Payment Advisory Commission. March 2019. Report to the Congress: Medicare Payment Policy. Washington, D.C.: Medicare Payment Advisory Commission. http://www.medpac.gov/-documents-/reports
Trish, Erin et. al. 2017. “Physician Reimbursement in Medicare Advantage Compared with Traditional Medicare and Commercial Health Insurance”. JAMA Internal Medicine. 177(9): 1287-1295. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2643349
Wallace, Jacob and Song, Zirui 2016. “Traditional Medical Versus Private Insurance: How Spending, Volume, and Price Change at Age Sixty-Five”. Health Affairs. 35(5): 864-872. https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2015.1195
White, Chapin et. al. 2013. “High and Varying Prices for Privately Insured Patients Underscore Hospital Market Power”. Center for Studying Health Systems Change, Research Brief No. 27. http://www.hschange.org/CONTENT/1375/1375.pdf
Biener, Adam and Selden, Thomas. 2017. “Public and Private Payments for Physician Office Visits”. Health Affairs. 36(12): 2160-2164. https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2017.0749
Pelech, Daria. 2018. “An Analysis of Private Sector Prices for Physicians’ Services”. Washington, D.C.: Congressional Budget Office, Working Paper 2018-01. https://www.cbo.gov/system/files/115th-congress-2017-2018/workingpaper/53441-workingpaper.pdf
Ginsburg, Paul. 2010. “Wide Variation in Hospital and Physician Payment Rates Evidence of Provider Market Power”. Center for Studying Health Systems Change, Research Brief No. 16. http://www.hschange.org/CONTENT/1162/#ib2
Medicare Payment Advisory Commission. March 2019. Report to the Congress: Medicare Payment Policy. Washington, D.C.: Medicare Payment Advisory Commission. http://www.medpac.gov/-documents-/reports
Medicare Payment Advisory Commission. March 2019. Report to the Congress: Medicare Payment Policy. Washington, D.C.: Medicare Payment Advisory Commission. http://www.medpac.gov/-documents-/reports
American Hospital Association. 2018. Trendwatch Chartbook 2018: Trends Affecting Hospitals and Health Systems. https://www.aha.org/guidesreports/2018-05-22-trendwatch-chartbook-2018
American Hospital Association. 2020. Fact Sheet: Underpayment by Medicare and Medicaid. Chicago, IL: American Hospital Association. https://www.aha.org/fact-sheets/2020-01-07-fact-sheet-underpayment-medicare-and-medicaid
Dranove, David and Lindrooth, Richard. 2003. "Hospital Consolidation and Costs: Another Look at the Evidence." Journal of Health Economics. 22: 983-997. https://www.ncbi.nlm.nih.gov/pubmed/14604556
Dranove, David et. al. 2002. “Is Managed Care Leading to Consolidation in Health-Care Markets?” Health Services Research. 37(3): 573-594. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1434652/
Gaynor, Martin and Vogt, William. 2003. "Competition Among Hospitals," The RAND Journal of Economics. 34:764-785. https://www.nber.org/papers/w9471
Gaynor, Martin et. al. 2015. "The Industrial Organization of Health-Care Markets." Journal of Economic Literature. 53(2): 235-84. https://www.aeaweb.org/articles?id=10.1257/jel.53.2.235
Feng, Yan et. al. 2015. “Association Between Market Concentration of Hospitals and Patient Health Gain Following Hip Replacement Surgery”. Journal of Health Services Research and Policy. 20(1): 11-17. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4268175/
Neprash, Hannah, et. al. 2015. “Association of Financial Integration Between Physicians and Hospitals with Commercial Health Care Prices”. JAMA Internal Medicine. 175(12):1932-1939. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2463591
Anderson, Gerard et. al. 2003. “It’s the Prices, Stupid: Why the United States Is So Different From Other Countries”. Health Affairs. 22(3): 89-105. https://www.healthaffairs.org/doi/full/10.1377/hlthaff.22.3.89
Anderson, Gerard et. al. 2019. “It’s Still the Prices, Stupid: Why the U.S. Spends So Much on Health Care, and a Tribute to Uwe Reinhardt”. Health Affairs. 38(1): 87-95. https://www.healthaffairs.org/doi/10.1377/hlthaff.2018.05144
Cooper, Zack et. al. 2018. “The Price Ain’t Right? Hospital Prices and Health Spending on the Privately Insured”. National Bureau of Economic Research, Working Paper 21815. Cambridge, MA: National Bureau of Economic Research. https://www.nber.org/papers/w21815
Burke, Leah and Ryan, Andrew. 2014. “The Complex Relationship Between Cost and Quality in U.S. Health Care”. AMA J. Ethics. 16(2): 124-130. https://journalofethics.ama-assn.org/article/complex-relationship-between-cost-and-quality-us-health-care/2014-02
Fulton, Brent. 2017. “Health Care Market Concentration Trends in the United States: Evidence and Policy Responses”. Health Affairs. 36(9): 1530-1538. https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2017.0556
Roberts, Eric et. al. 2017. “Market Share Matters: Evidence of Insurer and Provider Bargaining Over Prices”. Health Affairs. 36(1): 141-148. https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2016.0479
Medicare Payment Advisory Commission. March 2019. Report to the Congress: Medicare Payment Policy. Washington, D.C.: Medicare Payment Advisory Commission. http://www.medpac.gov/-documents-/reports
Colorado Department of Health Care Policy and Financing. 2019. Cost Shift Analysis Report January 2019. Colorado Healthcare Affordability & Sustainability Enterprise. https://www.colorado.gov/pacific/sites/default/files/2019%20January%20HCPF%20Cost%20Shift
%20Analysis%20Report%20Draft.pdfPelech, Daria. 2018. “An Analysis of Private Sector Prices for Physicians’ Services”. Washington, D.C.: Congressional Budget Office, Working Paper 2018-01. https://www.cbo.gov/system/files/115th-congress-2017-2018/workingpaper/53441-workingpaper.pdf
Ginsburg, Paul. 2010. “Wide Variation in Hospital and Physician Payment Rates Evidence of Provider Market Power”. Center for Studying Health Systems Change, Research Brief No. 16. http://www.hschange.org/CONTENT/1162/#ib2
Medicare Payment Advisory Commission. March 2019. Report to the Congress: Medicare Payment Policy. Washington, D.C.: Medicare Payment Advisory Commission. http://www.medpac.gov/-documents-/reports
Stensland, Jeffrey; Gaumer, Zachary; Miller, Mark. 2010. “Private-Payer Profits Can Induce Negative Medicare Margins”. Health Affairs. 29(5): 1041-1051. https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2009.0599
Schulman, Kevin and Milstein, Arnold. 2019. “The Implications of ‘Medicare for All’ for U.S. Hospitals”. JAMA. 321(17): 1661-1662. https://jamanetwork.com/journals/jama/fullarticle/2730485
Baker, Laurence et. al. 2014. “Physician Practice Competition and Prices Paid by Private Insurers for Office Visits”. JAMA. 312(16): 1653-1662. https://jamanetwork.com/journals/jama/fullarticle/1917436
Clemens, Jeffrey and Gottlieb, Joshua. 2017. “In the Shadow of a Giant: Medicare’s Influence on Private Physician Payments”. Journal of Political Economy. 125(1): 1-39. https://www.nber.org/papers/w19503
Dunn, Abe and Shapiro, Adam. 2014. “Do Physicians Possess Market Power?” Journal of Law and Economics. 57(1): 159-193. https://www.journals.uchicago.edu/doi/10.1086/674407?mobileUi=0&
Ginsburg, Paul. 2010. “Wide Variation in Hospital and Physician Payment Rates Evidence of Provider Market Power”. Center for Studying Health Systems Change, Research Brief No. 16. http://www.hschange.org/CONTENT/1162/#ib2
Kleiner, Samuel et. al. 2015. “Market Power and Provider Consolidation in Physician Markets”. International Journal of Health Economics and Management. 15(1): 99-126. https://link.springer.com/article/10.1007/s10754-014-9160-y?shared-article-renderer
Medicare Payment Advisory Commission. March 2019. Report to the Congress: Medicare Payment Policy. Washington, D.C.: Medicare Payment Advisory Commission. http://www.medpac.gov/-documents-/reports
American Medical Association Council on Medical Service. 2010. Report 1 of the Council on Medical Service (I-11): Practice Expense Data and the Medicare Economic Index. Chicago, IL: American Medical Association. https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/public/about-ama/councils/Council%20Reports/council-on-medical-service/i11-cms-practice-expense-data-medicare-economic-index.pdf
Voytal, Drew and Gelburd, Mollie. 2019. “Medicare Reimbursement Falls Short of Care Delivery Costs”. Medical Group Management Association. https://www.mgma.com/data/data-stories/2019-medicare-reimbursement-rates
Medicare Economic Index Technical Advisory Panel. 2012. Report to the HHS Secretary: Review of the Medicare Economic Index. Cambridge, MA: Massachusetts Institute of Technology Sloan School of Management. https://www.cms.gov/Regulations-and-Guidance/Guidance/FACA/Downloads/MEI-Review-Report-to-HHS.pdf
Medicare Payment Advisory Commission. March 2019. Report to the Congress: Medicare Payment Policy. Washington, D.C.: Medicare Payment Advisory Commission. http://www.medpac.gov/-documents-/reports
Government Accountability Office. 2007. Geographic Areas Used to Adjust Physician Payments for Variation in Practice Costs Should Be Revised. Washington, D.C.: United States Government Accountability Office. https://www.gao.gov/new.items/d07466.pdf
Berenson, Robert and Goodson, John. 2016. “Finding Value in Unexpected Places – Fixing the Medicare Physician Fee Schedule”. New England Journal of Medicine. 374: 1306-1309. https://www.nejm.org/doi/full/10.1056/NEJMp1600999
Gottlieb, Daniel et. al. 2010. “Prices Don’t Drive Regional Medicare Spending Variations”. Health Affairs. 29(3): 537-543. https://www.healthaffairs.org/doi/10.1377/hlthaff.2009.0609
American Medical Association Council on Medical Service. 2010. Report 1 of the Council on Medical Service (I-11): Practice Expense Data and the Medicare Economic Index. Chicago, IL: American Medical Association. https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/public/about-ama/councils/Council%20Reports/council-on-medical-service/i11-cms-practice-expense-data-medicare-economic-index.pdf
Medicare Economic Index Technical Advisory Panel. 2012. Report to the HHS Secretary: Review of the Medicare Economic Index. Cambridge, MA: Massachusetts Institute of Technology Sloan School of Management. https://www.cms.gov/Regulations-and-Guidance/Guidance/FACA/Downloads/MEI-Review-Report-to-HHS.pdf
Burgette, Lane et. al. 2018. Practice Expense Methodology and Data Collection Research and Analysis. Santa Monica, CA: RAND Corporation. https://www.rand.org/pubs/research_reports/RR2166.html
Burgette, Lane et. al. 2018. Practice Expense Methodology and Data Collection Research and Analysis. Santa Monica, CA: RAND Corporation. https://www.rand.org/pubs/research_reports/RR2166.html
American Medical Association Council on Medical Service. 2010. Report 1 of the Council on Medical Service (I-11): Practice Expense Data and the Medicare Economic Index. Chicago, IL: American Medical Association. https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/public/about-ama/councils/Council%20Reports/council-on-medical-service/i11-cms-practice-expense-data-medicare-economic-index.pdf
Medicare Payment Advisory Commission. March 2019. Report to the Congress: Medicare Payment Policy. Washington, D.C.: Medicare Payment Advisory Commission. http://www.medpac.gov/-documents-/reports
Medicare Payment Advisory Commission. March 2015. Report to the Congress: Medicare Payment Policy. Washington, D.C.: Medicare Payment Advisory Commission. http://www.medpac.gov/-documents-/reports
Medicare Payment Advisory Commission. March 2018. Report to the Congress: Medicare Payment Policy. Washington, D.C.: Medicare Payment Advisory Commission. http://www.medpac.gov/-documents-/reports
Medicare Payment Advisory Commission. March 2019. Report to the Congress: Medicare Payment Policy. Washington, D.C.: Medicare Payment Advisory Commission. http://www.medpac.gov/-documents-/reports