title: The Relationship between Commercial Health Care Prices and Medicare Spending and Utilization.
abstract: OBJECTIVE
  To explore the relationship between commercial health care prices and Medicare spending/utilization across U.S. regions.
  
  
  METHODS
  Claims from large employers and Medicare Parts A/B/D over 2007-2009.
  
  
  METHODS
  We compared prices paid by commercial health plans to Medicare spending and utilization, adjusted for beneficiary health and the cost of care, across 301 hospital referral regions.
  
  
  RESULTS
  A 10 percent lower commercial price (around the average level) is associated with 3.0 percent higher Medicare spending per member per year, and 4.3 percent more specialist visits (p < .01).
  
  
  CONCLUSIONS
  Commercial health care prices are negatively associated with Medicare spending across regions. Providers may respond to low commercial prices by shifting service volume into Medicare. Further investigation is needed to establish causality.
authors.affiliation: Schaeffer Center for Health Policy and Economics, Sol Price School of Public Policy, University of Southern California, Los Angeles, CA.
authors.forename: John A
authors.initials: JA
authors.lastname: Romley
authors.affiliation: Schaeffer Center for Health Policy and Economics, Sol Price School of Public Policy, University of Southern California, Los Angeles, CA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Axeen
authors.affiliation: Schaeffer Center for Health Policy and Economics, School of Pharmacy, Sol Price School of Public Policy, University of Southern California, Los Angeles, CA.
authors.forename: Darius N
authors.initials: DN
authors.lastname: Lakdawalla
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, MA.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Chernew
authors.affiliation: Stanford University School of Medicine, Stanford, CA.
authors.forename: Jay
authors.initials: J
authors.lastname: Bhattacharya
authors.affiliation: Schaeffer Center for Health Policy and Economics, School of Pharmacy, Sol Price School of Public Policy, University of Southern California, Los Angeles, CA.
authors.forename: Dana P
authors.initials: DP
authors.lastname: Goldman
mesh_terms: D003132:Commerce / Q000706:statistics & numerical data*; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D007345:Insurance Claim Review / Q000706:statistics & numerical data*; D007348:Insurance, Health / Q000191:economics*; D008297:Male; D006278:Medicare / Q000191:economics / Q000706:statistics & numerical data; D012111:Residence Characteristics / Q000706:statistics & numerical data; D014481:United States
keywords: Geographic variation; health care spending; provider competition and health care prices; spillovers in health care; supplied-inducer demand