Healthcare's high-stakes game of brinkmanship threatens patient care
For most Americans with private health insurance, hospital prices are not set by the government. Instead, they are set by hospitals and insurers that negotiate how much an insurer will pay when one of its members receives care.
Healthcare negotiations between hospitals and insurers have become a high-stakes game of brinkmanship, posing potential risks to patient care, according to a new study. Most Americans with private insurance have hospital prices negotiated by hospitals and insurers, not by government mandate. The threat of ending this relationship can provide leverage in negotiations, but it also creates uncertainty for patients who may need to switch health systems to maintain in-network care.
Research from Brown University's Center for Advancing Health Policy through Research (CAHPR) analyzed 14,918 hospital-insurer relationships from August 2021 to July 2025, revealing that about 1,249 cases involved publicly announced threats to end contracts. While 28% of these brinkmanship episodes led to a hospital leaving the network, 72% were resolved without a network exit.
For-profit hospitals, hospitals with positive operating margins, and national insurers were more likely to engage in public-facing brinkmanship. The study's authors argue that aggressive, public negotiations may not be the best approach to control healthcare spending, suggesting alternative systems like government pricing could be needed to balance affordability and potential drama in the healthcare system.
Written by urgent.news from Medical Xpress's reporting — not their text. Machine-written — may contain errors; check the original before relying on it.
