RAND 3.0 Results
Nationwide Evaluation of Health Care Prices Paid by Private Health Plans: Findings from Round 3 of an Employer-Led Transparency Initiative
by Christopher M. Whaley, Brian Briscombe, Rose Kerber, Brenna O’Neill, Aaron Kofner
Published September 2020
Our health care system consumes vast economic resources without producing commensurate health benefits. Employers, as purchasers of health benefits, have typically not played an active role in promoting the value of care or agreed on a strategy for doing it.
This study aimed to:
- Enable employers to be better-informed consumers when shopping for health plans and provider networks.
- Hold hospitals, hospital systems, and health plans accountable for the prices they have negotiated.
- Report hospital prices relative to a Medicare benchmark.
While the report from round 2 of the hospital price transparency study sheds light on hospitals in 25 states, work remains to be done. RAND is currently expanding the scope of our analysis to include additional self-funded employers. Participating self-funded employers in this round (Round 3) of the study have the option of receiving customized reports with hospital prices faced by their employee population. The more states and the more hospitals per state that participate in RAND 3.0, the more valuable it becomes to employers as it helps inform their local strategy towards paying for value.
This is the first broad-based study that reports prices paid by private health plans to hospitals identified by name and to groups of hospitals under joint ownership (hospital systems) identified by name.
*Employers who have Anthem, United Healthcare/UMR, and CIGNA do not need to complete a DUA. Please just email your insurer that you “intend to participate in the study by releasing to RAND claims data from 2016 through 2020”. Although these 3 organizations have agreements with RAND, your account representative may not be aware of this study, so it is important to cc Chris Whaley (firstname.lastname@example.org) and Brian Briscombe (email@example.com) who can guide them through the process
- OPTION 1: No charge (free) for contributing claims data to RAND for the PUBLIC report (grant funding is supporting this work), or
- OPTION 2: For employers, who in addition, will have a PRIVATE employer-level report: $0.20 per member (min of $1000, up to a max of $15,000 for jumbo employers)
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About the RAND Corporation
The RAND Corporation is a research organization that develops solutions to public policy challenges to help make communities throughout the world safer and more secure, healthier and more prosperous. RAND is a nonprofit 501(c)(3) headquartered in Santa Monica, California with offices in Washington, D.C., Pittsburgh, and Boston.
Associate Policy Researcher