Hospital Characteristics and Medicaid Hospital Prices
Using data from Elevance Health-affiliated Medicaid managed care plans, this study evaluated the relationship between selected hospital characteristics and hospital facility prices. For several routine children’s procedures, the study found significantly higher Medicaid prices at children’s hospitals, critical access hospitals, and system-affiliated hospitals.
Rising hospital costs, including facility fees at hospitals, are an important driver of increased healthcare costs. Certain types of hospitals can attain higher prices in the negotiating process with insurers.
This study assessed hospital facility prices for seven routine children’s procedures across nine hospital characteristics using data from Medicaid members in 23 states in 2021-2023. The analysis found that children’s hospitals and critical access hospitals, which may have greater market power due to special status in laws and regulations, tended to have higher prices for these procedures. Certain other factors, like rurality and government ownership, did not have a consistent relationship with price.
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