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Hospital Cost Shifting Adds to Auto Injury Claim Costs
Date:4/23/2010

surers to pay hospitals appropriately and help control auto injury claim costs," said Sprinkel.

Hospital cost shifting to auto injury claims illustrates the complex relationship between property-casualty insurance and the broader healthcare and insurance system. "Healthcare legislation enacted by Congress last month underscores the complexity of this relationship," said Sprinkel. "It will take months, if not years, to understand the full impact of the reforms on hospital cost shifting and the auto insurance system," said Sprinkel.

To explore the relationship between key health system features and auto injury hospital costs, IRC developed a statistical model of average hospital charges for auto injury claims in different states. Key predictors of average hospital charges confirmed by the model are the percentage of a state's population without health insurance coverage and the percentage of the population covered by Medicaid. To estimate excess hospital charges due to hospital cost shifting, IRC compared average hospital charges for BI liability claims in Maryland with average charges in 38 other tort and add-on states. In the 1970s, Maryland received a waiver from the federal government allowing it to regulate hospital reimbursement rates for all purchasers of hospital services. As a result, virtually all hospital cost shifting in the state was eliminated. Maryland's unique approach to hospital reimbursement, while unlikely to be replicated in other states, provides an opportunity to examine costs in an environment with minimal cost shifting. In all instances, IRC found that average hospital charges for auto injury claims in Maryland were substantially lower than hospital charges in most other states. IRC also found that the costs of expensive diagnostic procedures performed in Maryland hospitals were much lower than in other states but were more similar to costs in other states when the procedures were performed outside
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