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HSC: Provider-Carrier Dominance Varies

By staff Writer

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Hospitals and doctors in some U.S. communities are doing a better job of bargaining for higher rates than providers in other parts of the country.

Researchers at the Center for Studying Health System Change (HSC), Washington, a health care think tank, write about that finding in a report on visits to 12 U.S. heath care markets.

Health plans had only modest success with efforts to hold down provider rates in Miami and in Boston, but dominant Blue Cross and Blue Shield plans in some markets, such as Lansing, Mich., and Syracuse, N.Y., had the clout to hold down provider rates in their communities, the researchers say.

The researchers also found that:

  • Enrollment in health plans that incorporate health savings accounts or health reimbursement arrangement has grown, but few consumers get enough information about health care prices and quality to be able to shop for health care based on price, let alone to bargain for lower prices.
  • Hospitals are interested in hiring physicians, to get ready for health care payment reform initiatives, and physicians seem to be more interested in the idea of having a stable job at a hospital or a large provider group.

- Allison Bell

Other HSC coverage from National Underwriter Life & Health: