Study Finds ‘Staggering’ and ‘Inexcusable’ Variation in Negotiated Rates

Sep 27
Sep 27, 2024

Across the U.S., UnitedHealthcare’s negotiated commercial rates with hospitals for hip and knee replacements last year ranged from $11,203 to $106,427, according to a Sept. 20 analysis published in JAMA Health Forum. Meanwhile, the same study found that the negotiated rates for hip and knee replacements in the Chicago area varied significantly by hospital and payer.

Allison Oakes, Ph.D., the study’s lead author, tells AIS Health the variation was “staggering” and “inexcusable” and occurred even as insurers are subject to the Transparency in Coverage (TiC) rule that went into effect in 2022.
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Tim Casey

Tim has been a reporter and editor for newspapers, websites and magazines for more than 20 years, including 10 years covering health care business topics. He has a deep knowledge of the managed care industry and pharmacy benefit management. He also has experience covering medical conferences and clinical and legislative health care issues. In 2014, the Society for Advancing Business Editing and Writing selected Tim as one of 15 journalists to participate in a national symposium on the Affordable Care Act. Tim has a B.A. in Psychology from the University of Notre Dame and an M.B.A. from Georgetown University.