The majority of hospitals and health systems are in talks with payers about participating in health insurance exchanges, and a fourth of them have negotiated with at least five payers, according to a new survey from ReviveHealth and Catalyst Healthcare Research. Forty-five percent of survey respondents said they already have completed their negotiations with one payer. In general, the findings indicate hospitals and health systems expect to start negotiations with existing commercial rates; however, they anticipate ending up at a modest discount off commercial rates (10 percent or less). Survey (.pdf)