AHRQ Researchers Examine How Much Hospitals Are Paid for Inpatient Care

The amount that hospitals are paid for inpatient care can be estimated with moderate accuracy for patients covered by Medicare, Medicaid or private insurance, according to an AHRQ study. Using AHRQ’s Healthcare Cost and Utilization Project data and Medicare data from 2006, researchers reviewed inpatient charges from more than 1,000 community hospitals in 10 states. They then applied a “payment-to-charge” calculation that converted a hospital’s charges to an estimated payment for the inpatient care provided. Study authors stated that this calculation is currently the only method available to estimate fee-for-service payment for privately insured hospital stays, which represent a sizable amount of stays for patients younger than 65. “Predicting Inpatient Hospital Payments in the United States: A Retrospective Analysis” andabstract were published September 10 in BMC Health Services Research.