The Relationship between Commercial Health Care Prices and Medicare Spending and Utilization.
OBJECTIVE
To explore the relationship between commercial health care prices and Medicare spending/utilization across U.S. regions.


DATA SOURCES
Claims from large employers and Medicare Parts A/B/D over 2007-2009.


STUDY DESIGN
We compared prices paid by commercial health plans to Medicare spending and utilization, adjusted for beneficiary health and the cost of care, across 301 hospital referral regions.


PRINCIPAL FINDINGS
A 10 percent lower commercial price (around the average level) is associated with 3.0 percent higher Medicare spending per member per year, and 4.3 percent more specialist visits (p < .01).


CONCLUSIONS
Commercial health care prices are negatively associated with Medicare spending across regions. Providers may respond to low commercial prices by shifting service volume into Medicare. Further investigation is needed to establish causality.
['Romley|John A|JA|', 'Axeen|Sarah|S|', 'Lakdawalla|Darius N|DN|', 'Chernew|Michael E|ME|', 'Bhattacharya|Jay|J|', 'Goldman|Dana P|DP|']
D003132:Commerce D005260:Female D005102:Health Expenditures D006801:Humans D007345:Insurance Claim Review D007348:Insurance, Health D008297:Male D006278:Medicare D012111:Residence Characteristics D014481:United States
Geographic variation health care spending provider competition and health care prices spillovers in health care supplied-inducer demand