The DOI matches its Crossref record; 48 of the 48 references it cites were found in a registry or an index.
Prices Paid to Hospitals by Private Health Plans: Findings from Round 4 of an Employer-Led Transparency Initiative
Open accessAbstract
Because employer-sponsored spending comes from employee wages and benefits, employers have a fiduciary responsibility to administer benefits in the interest of participants. The lack of transparency of prices in the health care market limits the ability of employers to knowledgeably develop or implement benefit design decisions. This study uses medical claims data from a large population of privately insured individuals, including hospitals and other facilities from across the United States, and allows an easy comparison of hospital prices using a single metric. An important innovation of this study is that our data use agreements allow reporting on prices paid to hospitals and hospital systems (hospitals under joint ownership) identified by name.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“private insurances often adopt Medicare models, and our estimates may be conservative since private insurers typically reimburse more than Medicare.”
From Program cost and return on investment analysis of remote patient monitoring for hypertension management in the cardiology department of a large healthcare system (2026) · cites this paper as [38]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“another study found that in 2020, employers and private insurers paid 224 percent of what Medicare would have paid for the same services.38”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
It’s The Prices, Stupid: Why The United States Is So Different From Other Countries
Anderson, G. F., Reinhardt, U. E., Hussey, P. S., & Petrosyan, V. (2003) · Health Affairs · doi:10.1377/hlthaff.22.3.89 · Cited by 759
The Price Ain’t Right? Hospital Prices and Health Spending on the Privately Insured*
Cooper, Z., Craig, S., Gaynor, M., & Reenen, J. M. V. (2018) · The Quarterly Journal of Economics · doi:10.1093/qje/qjy020 · Cited by 581
The Industrial Organization of Health-Care Markets
Gaynor, M., Ho, K., & Town, R. (2015) · Journal of Economic Literature · doi:10.1257/jel.53.2.235 · Cited by 376
In the Shadow of a Giant: Medicare’s Influence on Private Physician Payments
Clemens, J., & Gottlieb, J. D. (2017) · Journal of Political Economy · doi:10.1086/689772 · Cited by 316
The Pricing Of U.S. Hospital Services: Chaos Behind A Veil Of Secrecy
Reinhardt, U. E. (2006) · Health Affairs · doi:10.1377/hlthaff.25.1.57 · Cited by 297
Changes in Quality of Care after Hospital Mergers and Acquisitions
Beaulieu, N. D., Dafny, L., Landon, B. E., Dalton, J. B., Kuye, I. O., & McWilliams, J. M. (2020) · New England Journal of Medicine · doi:10.1056/nejmsa1901383 · Cited by 289
Anderson, G. F., Hussey, P. S., & Petrosyan, V. (2019) · Health Affairs · doi:10.1377/hlthaff.2018.05144 · Cited by 240
Munnich, E. L., & Parente, S. T. (2014) · Health Affairs · doi:10.1377/hlthaff.2013.1281 · Cited by 193
The Labor Market Effects of Rising Health Insurance Premiums
D, K. B. A., & Chandra, A. (2006) · Journal of Labor Economics · doi:10.1086/505049 · Cited by 184
Do hospital mergers reduce costs?
Schmitt, M. (2017) · Journal of Health Economics · doi:10.1016/j.jhealeco.2017.01.007 · Cited by 156
Research works printed but not linked: 2
- McGinty Tom, Mathews Anna Wilde, Evans Melanie Wall Street Journal. March 22, 2021. , “Hospitals Hide Pricing Data from Search Results,”. , .
- Medicare Payment Advisory Commission March 2022 Report to the Congress: Medicare Payment Policy. Washington, D.C.: MedPAC; March 15, 2022. , , : , . [Google Scholar]
Cited by
Sorted by citations
Bonner, S. N., Thumma, J. R., Dimick, J. B., & Sheetz, K. H. (2023) · JAMA Network Open · doi:10.1001/jamanetworkopen.2023.15052 · Cited by 27
Options for states to constrain pricing power of health care providers
Gudiksen, K. L., & Murray, R. B. (2022) · Frontiers in Health Services · doi:10.3389/frhs.2022.1020920 · Cited by 17
Large self-insured employers lack power to effectively negotiate hospital prices
Eisenberg, M. D. (2021) · The American Journal of Managed Care · doi:10.37765/ajmc.2021.88702 · Cited by 17
Hospital resource allocation decisions when market prices exceed Medicare prices
Wang, Y., & Anderson, G. F. (2021) · Health Services Research · doi:10.1111/1475-6773.13914 · Cited by 15
Site‐based payment differentials for ambulatory services among individuals with commercial insurance
Sen, A. P., Singh, Y., & Anderson, G. F. (2022) · Health Services Research · doi:10.1111/1475-6773.13935 · Cited by 14
Metadata
- Authors
- Whaley, C., Briscombe, B., Kerber, R., O'Neill, B., & Kofner, A.
- Venue
- RAND Health Quarterly
- Publisher
- Rand Corporation
- Published
- 2022
- Volume
- 10
- Issue
- 1
- Pages
- 5-5
- ISSN
- 2162-8254 (ISSN-L)
- PMC
- PMC9718062
- OpenAlex
- W4285121137
- Cited by
- 28
- References
- 48
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 9 · 2023: 8 · 2022: 3
- FWCI
- 4.83
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Rand health quarterly (publishedVersion)
- RAND Corporation eBooks (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Healthcare Systems and Reforms
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Pharmaceutical Economics and Policy
- Keywords
- hospital prices, private health plans, employer-sponsored health insurance, price transparency, fiduciary obligations, benefit design, hospital systems, hospital ownership, health insurance claims data, health care costs
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
How to cite
Cite CoChat for the checks on this page, and the paper for its own findings.
- This page
- CoChat. (2026). Citation check: Prices Paid to Hospitals by Private Health Plans: Findings from Round 4 of an Employer-Led Transparency Initiative. https://app.cochat.ai/papers/10.7249/rhq-10-01-05
- The paper
- Whaley, C., Briscombe, B., Kerber, R., O'Neill, B., & Kofner, A. (2022). Prices Paid to Hospitals by Private Health Plans: Findings from Round 4 of an Employer-Led Transparency Initiative. RAND Health Quarterly. https://doi.org/10.7249/rhq-10-01-05
