An employer coalition in Indiana sponsored a study by the Rand Corporation examining commercial insurer payments as a percent of Medicare. The employers sought to understand why their health care costs were high and increasing. The study showed that, on average, their insurer was paying three times what Medicare pays for the same services. In this, a follow-up study, we demonstrate that these high payments resulted in very high profit margins for central Indiana’s major health systems, along with elevated costs and poor performance on key efficiency measures. We also see indications that hospitals appear to be using aggressive revenue cycle management techniques. The paper concludes with a discussion of policy issues.

中文翻译：

---

商业超额报销对医院的影响：印第安纳州中部一个奇怪的案例。

印第安纳州的一个雇主联盟赞助了兰德公司（Rand Corporation）的一项研究，研究商业保险公司的付款占医疗保险的百分比。雇主试图了解为什么他们的医疗保健费用高且不断增加。研究表明，平均而言，他们的保险公司所支付的费用是医疗保险为相同服务支付的费用的三倍。在此后续研究中，我们证明了这些高额付款为印第安纳中部的主要卫生系统带来了非常高的利润率，以及成本上升和关键效率指标的不良表现。我们还看到有迹象表明医院似乎正在使用积极的收入周期管理技术。本文最后讨论了政策问题。