October 30, 2023

A closer look at variations in regional health insurance prices

Editor's Note

This new study in JAMA Health Forum is one of the first to review publicly available insurer price data and compare regional rate differences. The research was published by JAMA Network on October 27.

Following are some highlights:

  • Over half of the US population receives health insurance from private insurers, involving a negotiation process for rates that are higher than Medicare and highly variable. 
  • The researchers looked at Humana's negotiated rates for seven procedures as of October 2022, including colonoscopies, office visits, and emergency department visits.
  • Rates paid to providers for office visits ranged from $69 to $114 across the country. 
  • The study found higher rates for office visits and medical procedures in the Upper Midwest and Southeast, and the lowest costs in the Central U.S. and Florida.

Overall, commercial health insurer payments to hospitals and physicians have been rising sharply, and these increased costs have led to higher health insurance costs for consumers.

JAMA (healthcare publication) Network logo


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