Becker’s Hospital Review: California hospitals paid 209% of Medicare by private insurers, study finds


by Morgan Haefner

Hospitals in California were paid, on average, 209 percent as much as Medicare by private health insurers in 2015-16, according to research firm West Health Policy Center.

The center’s analysis of financial data filed by hospitals with the California Office of Statewide Health Planning and Development found that while Medicare paid an average of 79 percent of cost, private insurers paid an average of 165 percent of cost — more than twice as much as Medicare.

Researchers uncovered substantial variation in how hospitals’ private insurance payments compared to Medicare reimbursement. Private insurance payments averaged 364 percent of Medicare for the 10 percent of California hospitals with the highest ratio of private to Medicare payments. Comparatively, for the 10 percent with the lowest ratio, average private insurance payments were 89 percent of Medicare.

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