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Area of Science:

  • Health economics
  • Healthcare policy
  • Hospital finance

Background:

  • Rhode Island implemented hospital affordability standards in 2010 to control price growth.
  • The long-term effects of these standards on hospital prices and insurance markets were previously unknown.

Purpose of the Study:

  • To evaluate the long-term impact of Rhode Island's affordability standards on hospital prices, hospital margins, and insurance premiums.
  • To compare trends in Rhode Island with those in comparable states.

Main Methods:

  • Utilized national data from 2006-2022, comparing Rhode Island to control states.
  • Analyzed hospital prices, hospital margins, and insurer premiums and fees before and after 2010.

Main Results:

  • Hospital prices in Rhode Island decreased by an average of 9% relative to comparison states.
  • Fully insured premiums decreased by up to $1,000 per member annually.
  • Self-insured premiums increased, offsetting some gains.
  • Hospitals experienced an annual revenue reduction of nearly $160 million.

Conclusions:

  • Rhode Island's affordability standards significantly reduced hospital prices and fully insured premiums.
  • The standards benefited employers and fully insured members but reduced hospital revenue.
  • The impact on overall commercial premiums was modest due to increases in the self-insured market.