Private Insurers Pay Twice (or More) for Physician, Hospital Services than Medicare

At the same time that it issued its assessment of the Senate's new health care plan, the Congressional Budget Office (CBO) released a related report comparing physician and hospital costs when paid by private insurers and when paid by Medicare and Medicare Advantage. The CBO found the average commercial payment rate for hospital admission was $21,400 in 2013, compared to $11,400 for a Medicare patient, which was slightly more than for a Medicare Advantage patient ($10,700). The CBO also found private insurance pays physicians much more than Medicare, particularly for brain MRIs, intensity-modulated radiation therapy, abdominal MRIs and knee arthroscopy. The highest physician payments for those services were at least 350 percent higher than Medicare payments. The average for those procedures was more than 200 owexwbr higher for private payers compared to Medicare. Access the full report, An Analysis of Private-Sector Prices for Physician Services.