Comparing Private Payer and Medicare Payment Rates for Select Inpatient Hospital Services

(By Eric Lopez, Gary Claxton, Karyn Schwartz, Matthew Rae, Nancy Ochieng, and Tricia Neuman for Kaiser Family Foundation)

As the total number of people who have been hospitalized for COVID-19 continues to rise across the U.S., there is increasing interest in the pandemic’s impact on costs incurred by patients, public and private payers, and revenues for hospitals and other health care providers. With many severely ill COVID-19 patients requiring hospital care, the pandemic provides a window into the large gap between what hospitals charge private insurers and what Medicare pays. As of June 20, 2020, 43% of patients hospitalized for COVID-19 in the United States were age 65 or older,1 virtually all of whom have Medicare coverage. Proposals like a public option or lowering the age of Medicare eligibility would give more people access to coverage with lower payments rates and premiums, while also resulting in lower revenues for health care providers.  Continue reading here…

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