Outpatient Facilities Negotiate Better Reimbursement Rates Than Physicians, Study Says

Hospitals and outpatient surgery centers have been more successful at bargaining for higher rates from employer-sponsored health plans than physicians in 2012 so far, according to data from Milliman Inc. in Seattle.

The report, called the 2012 Milliman Medical Index, used care cost data from the company to estimate the average healthcare costs for a typical U.S. family of four receiving healthcare through an employer-sponsored PPO plan. The report analyzed factors such as the cost of inpatient hospitalization, outpatient care, professional services and pharmacy services. The analysis does not include the cost of long-term care or insurance plan administration costs.

The average cost has increased 6.9 percent since 2011, to $20,728, but the analysts found that costs are rising more rapidly for some types of care than others. Hospital costs are up 7.6 percent, and other outpatient care costs are up 8.6 percent, while physician costs are up just 5 percent.

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