5 research outputs found
Assessing the Complex and Evolving Relationship between Charges and Payments in US Hospitals: 1996 – 2012
<div><p>Background</p><p>In 2013 the United States spent 1 charged varies significantly across three dimensions: payer, year, and cause. Among the 10 largest causes of health care spending, average payments range from 23 to 55 cents per dollar charged. Over time, the amount paid per dollar charged is decreasing for those with private or public insurance, signifying that inpatient charges are increasing faster than the amount insurers pay. Conversely, the amount paid by out-of-pocket payers per dollar charged is increasing over time for several causes. Applying our estimates to a nationally representative hospital charge sample generates payment estimates which align with the official US estimates of inpatient spending.</p><p>Conclusions</p><p>The amount paid per $1 charged fluctuates significantly depending on the cause of a health care encounter and the primary payer. In addition, the amount paid per charge is changing over time. Transparent accounting of hospital spending requires a detailed assessment of the substantial and growing gap between charges and payments. Understanding what is driving this divergence and generating accurate spending estimates can inform efforts to contain health care spending.</p></div
Weighted average from 1996–2012 of estimated payment ratios with 95% uncertainty intervals, shown by payer for the 10 largest causes of spending and the weighted average of all causes.
<p>Weighted average from 1996–2012 of estimated payment ratios with 95% uncertainty intervals, shown by payer for the 10 largest causes of spending and the weighted average of all causes.</p
Estimated payment ratios by cause and payer in 1996 and 2012, with 95% uncertainty intervals and direction of change over time.
<p>Estimated payment ratios by cause and payer in 1996 and 2012, with 95% uncertainty intervals and direction of change over time.</p
Interstitial lung disease charges and estimated payments in NIS, with estimated payment ratios and 95% uncertainty intervals, shown for each payer over time.
<p>Interstitial lung disease charges and estimated payments in NIS, with estimated payment ratios and 95% uncertainty intervals, shown for each payer over time.</p
Time trends of all-payer charges and estimated payments in NIS, stratified by cause, with the NHEA inpatient total shown for comparison.
<p>Time trends of all-payer charges and estimated payments in NIS, stratified by cause, with the NHEA inpatient total shown for comparison.</p