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New Study: Site Of Care A Key Driver Of Higher Health Care Prices For Patients

by Clare Krusing

March 9, 2016

For Immediate Release

Washington, D.C. – As overall health spending continues to rise, a new study by America’s Health Insurance Plans (AHIP), published in The American Journal of Managed Care (AJMC), found that price variation based on where a service was performed led to $1.9 billion in additional health care spending on seven commonly-performed medical services in 2013.

The study examined price variations for the same services between hospital outpatient departments and physician offices or ambulatory surgery centers for individuals with employer-sponsored insurance. According to the findings, payments for services performed in hospital outpatient departments were significantly higher than payments for the same service performed in a physician’s office.

Key findings include:

  • In 2013, the price of a routine office visit conducted in a hospital outpatient department was 21 percent higher than if it had been conducted in a physician’s office.
  • The price for chest radiography performed in a hospital outpatient department was 258 percent higher than for the same service performed in a physician’s office.
  • An increase in price variation, combined with a shift in favor of services being performed in hospital outpatient departments, led to a 44 percent increase in total health spending from 2008-2013.

To view the full study, click here.
About the Journals and AJMC.com 
The American Journal of Managed Care is the leading peer-reviewed journal dedicated to issues in managed care. AJMC.com distributes healthcare news to leading stakeholders across a variety of platforms. Other titles in the franchise include The American Journal of Accountable Care, which publishes research and commentary on innovative healthcare delivery models facilitated by the 2010 Affordable Care Act. AJMC’s Evidence-Based series brings together stakeholder views from payers, providers, policymakers and pharmaceutical leaders in oncology and diabetes management. To order reprints of articles appearing in AJMC publications, please call (609) 716-7777, x 131.

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