AHRQ Stats: Payments Vary for Public, Private Physician Office Visits

Medicaid payments to physicians for office visits in 2014-15 averaged 62 percent of payments made to physicians by employer-sponsored insurance. (Source: Public and Private Payments For Physician Office Visits, Health Aff. 2017 Dec;36(12):2160-2164.)

2017 Dec;36(12):2160-2164. doi: 10.1377/hlthaff.2017.0749.

Public And Private Payments For Physician Office Visits.

Biener AI1, Selden TM2.

Author information

Abstract

We used data for 2014-15 from the Medical Expenditure Panel Survey to estimate standardized payments for nonelderly adults' physician office visits by type of insurance. Adults with public insurance, especially Medicaid, had substantially lower provider payments, out-of-pocket spending, and third-party payments than their peers with employer-sponsored or Marketplace insurance. Quantifying public-private payment differences can help clarify choices for financing health care among low-income Americans.