High-price hospitals average 474 staffed beds, more than double the average number of beds in the low-price hospitals, and have market shares about three times as large as those of low-price hospitals, according to a study.
The study, published Jan. 29 on the website of the journal Health Affairs, explored why some hospitals are more successful at negotiating higher prices than nearby competitors, and linked hospital-specific negotiated private prices with detailed information of hospital characteristics.
The high-price hospitals were almost three times as likely to be teaching hospitals, were much more likely to offer specialized facilities and services, and received significantly higher revenues from sources other than patient care.
In national rankings of hospitals reputations, high-price hospitals scored higher, but clinical outcomes measures were mixed. High-price hospitals performed better on one measure of mortality (for patients with heart failure), but performed worse than the low-price hospitals on measures of excess readmissions and on patient-safety indicators, including postsurgical deaths and complications.
The study used 2011 facility claims for current and retired autoworkers and their dependents in 10 U.S. metropolitan markets. There were a total of 110 hospitals evaluated in the study, based on 24,187 inpatient stays.
Insurers may face resistance if they attempt to steer patients away from high-price hospitals because they have good reputations and offer specialized services that maybe unique in their markets, the authors wrote. More radical approaches such as state-based rate setting or restrictions on contracting arrangements between hospitals and health plans may gain traction.