hospital prices are set by a regulator (as is true for prices for health care services in most
countries), hospital prices for the privately insured are market-determined. However, this may change wth the Affordable Care Act, the transition from volume based reimbursement to new models of care, including quality of care and HEDIS scores which reflect hospital and health care compliance with recomendations from NQAH.
transaction prices – have been treated as commercially sensitive and have been largely
unavailable to researchers. As a result, there is a great deal that is unknown about how and why
health care providers’ prices vary across the nation and the extent to which providers’ negotiated
prices influence overall health spending for the privately insured.
The Experts Were Wrong About the Best Places for Better and Cheaper Health Care - The New York Times