Hospital reimbursement varies widely in Rhode Island

A new study by Rhode Island state officials has concluded that commercial payments to hospitals in the state vary widely. According to the Rhode Island Office of the Health Insurance Commissioner, the average payment per inpatient stay was about 116 percent of Medicare rates statewide.

However, at one hospital, Roger Williams Medical Center in Providence, commercial reimbursement sat at about 79 percent of Medicare reimbursement. Meanwhile, average payment per inpatient stay ran to 167 percent of Medicare at Kent Hospital in Warwick, the health insurance commissioner reported.

How could observers predict how hospitals would get paid? The state concluded that the largest factor determining commercial reimbursement was affiliation with a given health system. For example, hospitals tied to Care New England received payments averaging 149 percent of Medicare, while Lifespan hospitals received 117 percent of Medicare. Hospitals with no affiliation received payments averaging 97 percent of Medicare reimbursement.

To find out more about this research:
- read the state's report (.pdf)

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