Does Insurance Status Influence a Patient’s Hospital Charge?

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: There is obscurity regarding how US hospitals determine patients’ charges. Whether insurance status influences a patient’s hospital charge has not been explored. Objective: The objective of this study was to determine whether hospitals charge patients differently based on their insurance status. Methods: This was an analysis of the Florida Hospital Inpatient Data File for fiscal years 2011–2012 (N = 4.7 million). Multivariable regression analysis was used to adjust for patients’ age, sex, length of stay, priority of admission, principal ICD-9-CM diagnosis, and All Payer Refined Diagnosis-Related Group subdivided by Severity of Illness subclass. Hospital fixed effects were included to account for differences in hospitals’ markups. Results: Compared with those with no insurance, patients with private insurance received hospital bills that were an average of 10.7% higher and patients with Medicare received bills that were an average of 8.9% higher. The impact of Medicaid coverage was imprecisely estimated, but the magnitude of the point-estimate was consistent with 3.5% higher charges to Medicaid patients, relative to the uninsured. Conclusion: Conditional on patient characteristics, length of stay, and expected intensity of resource utilization, patients with private insurance and patients with Medicare were charged more (before discounting) than their uninsured counterparts within the same hospital.

Original languageEnglish (US)
Pages (from-to)1-10
Number of pages10
JournalApplied Health Economics and Health Policy
DOIs
StateAccepted/In press - Feb 6 2017

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Hospital Charges
Insurance Coverage
Insurance
Medicaid
Medicare
Length of Stay
Hospital charges
Information Storage and Retrieval
Diagnosis-Related Groups
International Classification of Diseases
Inpatients
Regression Analysis

ASJC Scopus subject areas

  • Economics and Econometrics
  • Health Policy

Cite this

Does Insurance Status Influence a Patient’s Hospital Charge? / Woodworth, Lindsey; Romano, Patrick S; Holmes Jr, James F.

In: Applied Health Economics and Health Policy, 06.02.2017, p. 1-10.

Research output: Contribution to journalArticle

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