Doctor with piggy bank Family medicine, obstetrics and gynecology, dermatology, ophthalmology and psychiatry had the lowest commercial markups relative to Medicare prices, averaging about 110% or less of Medicare rates. (Photo: iStock)

Private insurers generally pay physicians substantially higher rates than Medicare does for the same service. This differential could have implications for debates over physician payment reforms, public option and single-payer policies, and Medicare payment reforms.

“Policy proposals to reduce commercial prices and curb health care spending by benchmarking private payment rates to Medicare prices could significantly affect physician payments, but the effects will likely vary considerably by specialty,” according to a new report from the Urban Institute.

Complete your profile to continue reading and get FREE access to, part of your ALM digital membership.

Your access to unlimited content isn’t changing.
Once you are an ALM digital member, you’ll receive:

  • Critical information including cutting edge post-reform success strategies, access to educational webcasts and videos, resources from industry leaders, and informative Newsletters.
  • Exclusive discounts on ALM, BenefitsPRO magazine and events.
  • Access to other award-winning ALM websites including and

Already have an account?



Join BenefitsPRO

Don’t miss crucial news and insights you need to navigate the shifting employee benefits industry. Join now!

  • Unlimited access to - your roadmap to thriving in a disrupted environment
  • Access to other award-winning ALM websites including and
  • Exclusive discounts on and ALM events.

Already have an account? Sign In Now
Join BenefitsPRO

Copyright © 2023 ALM Global, LLC. All Rights Reserved.