

Andrew Ryan on State Affordability Standards' Impact on Hospital Prices and Insurance Premiums
May 27, 2025
In this discussion, Andrew Ryan, a Health Services expert from Brown University, delves into Rhode Island's groundbreaking affordability standards. He highlights how these standards have significantly reduced hospital prices and influenced insurance premiums. Listeners learn about the nuances of the regulatory framework and the impact on both fully insured and self-funded plans. Ryan also addresses the declining hospital revenue and the implications for financial health in the sector. Excitingly, he explores the potential for global budgeting and hospital price caps to further enhance affordability.
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Unique Price Growth Caps
- Rhode Island's affordability standards cap hospital price growth, uniquely overseen by the Office of the Health Insurance Commissioner.
- The slow phase-in minimized pushback and allowed gradual, significant price reductions over time.
Broad Price Cuts, Uneven Premium Drops
- Rhode Island's standards cut hospital prices about 9%-15% statewide, affecting both fully insured and self-funded plans.
- Premium reductions appeared mainly in the fully insured market, despite price drops also in self-funded plans.
Explaining Self-Funded Premium Discrepancies
- Self-funded plans showed limited premium reductions possibly due to insurer fees retaining savings and dispersed costs across multi-state employees.
- This dilution challenges states in ensuring savings benefit local employer groups.