Report Finds Employer Insurance Plans are Paying More for Hospital Care in Wisconsin

A national report shows employer-sponsored health insurance plans in Wisconsin pay significantly more than Medicare prices.

The report by the RAND Corporation looked at insurance claims data provided by employers and health plans. It found that the costs paid by private insurance in 2022 were 318 percent higher in Wisconsin than the estimated price paid by Medicare for the same services. That puts Wisconsin at the fifth highest in the country, with the national average coming in at 254 percent.

Rachel Ver Velde, WMC’s associate vice president of government relations, said it’s a national issue, but Wisconsin’s even higher prices puts employers in the state at a disadvantage.

Ver Velde said part of the problem behind higher prices is the growing consolidation among hospitals. The RAND report said researchers found a correlation between how much prices varied for private insurance and the amount of market share a hospital controlled in a state.

It’s far from the first report to point to consolidation as a negative impact on prices. KFF, which provides health policy research, reports that a substantial body of research shows that consolidation has led to higher health care prices, with the strongest evidence related to hospitals.