The Congressional Budget Office released a report analyzing private-sector pricing for physicians claiming these physicians charge commercial payers higher rates than the government, Twin Cities Business reports.
Here's what you should know:
1. Researchers examined paid claims data for Aetna, Humana and UnitedHealthcare for 21 "[frequent] and costly" physician services. These services occurred more than 50,000 times annually at more than $450 per claim on average. They compared the claims data to Medicare Part B and D data.
2. The researchers reviewed approximately 50 million commercial claims and 19 million Medicare claims.
3. For a service like a new patient visit, physicians charged commercial payers 6 percent to 30 percent more than what they charged Medicare.
4. For specialty services prices were 30 percent to 140 percent higher for commercial payers.
5. Researchers concluded, "Prices for physicians’ services affect premiums in commercial insurance plans, which are subsidized both by the preferential tax treatment of employer-based insurance and through direct subsidies in health insurance marketplaces."