Roslyn C. Murray (
Zach Y. Brown, University of Michigan.
Health Aff (Millwood). 2024 Mar;43(3):424-432. doi: 10.1377/hlthaff.2023.01021.
Hospital prices for commercially insured people are high and vary widely, prompting states to seek ways to control hospital price growth. In October 2019, the Oregon state employee health insurance plan instituted a cap on hospital payments. Using 2014-21 data from the Oregon All Payer All Claims Reporting Program database, we performed a difference-in-differences analysis to test the impact of the cap on hospital facility prices for Oregon's state employee plan enrollees. We found that the cap was not associated with a significant reduction in inpatient facility prices across the post period (-$901.9 per admission) but was associated with a significant reduction in the second year after implementation (-$2,774.20). The cap was associated with a significant reduction in outpatient facility prices over the course of the first twenty-seven months of the policy (-$130.50 per procedure). We estimated $107.5 million (or 4 percent of total plan spending) in savings to the state employee plan during the first two years. The hospital payment cap successfully reduced hospital prices for enrollees in that plan.
商业保险患者的医院价格偏高且差异较大,促使各州寻求控制医院价格增长的方法。2019 年 10 月,俄勒冈州员工健康保险计划对医院支付款项设置了上限。我们利用俄勒冈州所有支付者所有索赔报告计划数据库 2014-21 年的数据,采用差异中的差异分析方法来检验上限对俄勒冈州员工计划参保人医院设施价格的影响。我们发现,上限并没有显著降低住院设施价格(每次入院减少 901.9 美元),但在实施后的第二年却显著降低了(减少 2774.20 美元)。在政策实施的前 27 个月,上限与门诊设施价格的显著降低有关(每次就诊减少 130.50 美元)。我们估计,在最初的两年中,该州员工计划节省了 1.075 亿美元(占总计划支出的 4%)。医院支付上限成功降低了该计划参保人的医院价格。