How do doctors and insurers set prices? New data offer a glimpse

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  • Analysis of a national database of medical claims offers new insight into the relative clout of physicians and insurers with varying amounts of market share.
  • The study, published in Health Affairs, shows that smaller medical practices and health plans are often outmaneuvered by larger competitors.
Why this matters
  • Small doctor's offices billed insurers an average of $72 for an uncomplicated, routine visits; larger practices billed $86 on average. 
  • Similarly, smaller health plans end up paying more than big ones, the stud...