Hospitals being paid rates much higher than what Medicare would pay

The Jackson Hole News & Guide is reporting this week that Wyoming’s self-insured employers are paying hospitals much more than what Medicare would pay for the same services, according to a RAND Corporation study.

According to the News & Guide, St. John’s Medical Center in Jackson is the Wyoming hospital that charges the least-above-Medicare rates for outpatient services. The standard price for all outpatient services was just over $220, or 284% of what Medicare would pay. On the other end of that spectrum is SageWest Health Care in Riverton, with a standard price of roughly $652, or 830% of what Medicare would pay.

Inpatient payments ranged from 125% of Medicare at Memorial Hospital of Sweetwater County in Rock Springs to 347% of Medicare at Wyoming Medical Center in Casper. In Wyoming the relative price for inpatient and outpatient services is just over 300%.

According to RAND, this is the first broad study that reports prices paid by private health plans to hospitals identified by name in a searchable Excel spreadsheet. The examination of hospital prices from 2015 to 2017 spans 25 states and 1,598 hospitals.