Patients with private insurance can face higher health costs at hospitals

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Berkeley Lovelace Jr. is a health and medical reporter for NBC News. He covers the Food and Drug Administration, with a special focus on Covid vaccines, prescription drug pricing and health care. He previously covered the biotech and pharmaceutical industry with CNBC.

People with private health insurance might pay higher prices for procedures or tests at a hospital. A report published Monday from the research group Rand Corp. found that in 2022, the prices hospitals charged to private and employer-based insurance providers were, on average, 254% higher than what Medicare would have paid for the same services.

“But as you get more market share, you kind of become the big game in town and it becomes very hard for an employer to say, ‘We won’t use that hospital.’” Meanwhile, Medicare often pays less in part because it has more negotiating power with hospitals, said Cynthia Cox, a vice president at KFF, a group that researches health policy issues. Most people on Medicare are older adults with underlying health conditions and represent a large portion of hospital revenue.

 

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