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An Analysis of Private-Sector Prices for Physicians’ Services: Working Paper 2018-01

Author

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  • Daria Pelech

Abstract

Physicians’ services account for a substantial portion of health care spending in the United States. Using 2014 claims data from three major insurers, we analyzed the prices paid for 20 common services and compared those prices with the estimated amounts that Medicare’s fee-for-service (FFS) program would pay for the same services. We found that average commercial prices were substantially higher than Medicare FFS prices and were up to three times higher out of network than in network. In contrast, average prices paid by those insurers in their Medicare Advantage plans were

Suggested Citation

  • Daria Pelech, 2018. "An Analysis of Private-Sector Prices for Physicians’ Services: Working Paper 2018-01," Working Papers 53441, Congressional Budget Office.
    • Handle: RePEc:cbo:wpaper:53441
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    File URL: https://www.cbo.gov/system/files/115th-congress-2017-2018/workingpaper/53441-workingpaper.pdf
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    References listed on IDEAS

    as
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    More about this item

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private

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