Nonprofit Indiana hospital systems under lawmaker pricing benchmark in second annual state analysis

Nonprofit Indiana hospital systems under lawmaker pricing benchmark in second annual state analysis

Leslie Bonilla Muñiz

Tue, February 10, 2026 at 1:07 PM UTC

3 min read

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Indiana's five largest nonprofit hospital systems all came in under the statutory pricing benchmark in 2024, with an average of 252% of what Medicare would have paid.
The Indiana Hospital Association celebrated the results as evidence that hospitals are lowering prices, while the Employers' Forum of Indiana raised concerns about the inclusion of physician fees in the reported prices.
Milliman's analysis of the hospital systems' pricing also showed variations in percentages when comparing different types of services and market segments, cautioning against direct comparisons between the systems.

The Indiana Statehouse on Oct. 10, 2025. (Photo by Niki Kelly/Indiana Capital Chronicle)

The state’s five largest nonprofit hospital systems again cleared a statutory pricing benchmark in 2024, according to the latest report commissioned by the Indiana Department of Insurance.

The analysis, by actuarial consultant Milliman, includes Ascension Health, Community Health Network, Franciscan Health, Indiana University Health and Parkview Health — minus critical access hospitals. It was the second edition of the annual report.

Prices for the commercially insured market were compared to 285% of what Medicare would have paid, in accordance with 2023’s House Enrolled Act 1004. The 65-page document was completed in November but uploaded publicly late last month.

All five systems came in under the benchmark for 2024, per the report:

Ascension: 254%
Community: 236%
Franciscan: 271%
IU Health: 237%
Parkview: 262%

The Indiana Hospital Association celebrated the results, describing the 252% average as a full 33 percentage points below lawmakers’ reference point.

“The data is clear: Indiana hospitals are lowering prices while navigating some of the most difficult financial conditions in recent history,” said Scott B. Tittle, the organization’s president, in a Tuesday news release.

Tittle called on insurers to pass those savings along.

But not everyone is applauding. The Employers’ Forum of Indiana said “the inclusion of professional fees for medical groups owned by the hospitals has a material effect upon reported prices, reducing average “hospital” prices (aka, facility prices) by 30 to more than 50 percentage points.”

Physician fees “should not be averaged with hospital facility fees because this mingling gives misleading information on the prices for each,” the employer-led health care coalition added Monday night.

The hospital association, meanwhile, said Indiana’s insurer-set physician reimbursement rates are among the lowest in the country, forcing hospitals to subsidize physician practices.

Each system met the benchmark across three years of analysis. The 2024 results, however, showed across-the-board decreases from 2023, with more mixed results compared to 2022.

Practitioner services were calculated at over 100% of Medicare for the five systems. Inpatient care was above 200% of Medicare, while outpatient services were at or above 300%.

Milliman cautioned that the percentages should each only be compared to the 285% standard, and not to each other.

That’s because the “full Medicare” figures include the hospital-specific payments Medicare provides for inpatient services. All of the hospitals included in the report have one or more hospital-specific adjustments, which the consultants noted increase their reimbursement from Medicare by up to 52%.

Milliman also performed “modified Medicare” calculations, without the hospital-specific payments, to produce numbers that could be compared across hospital systems — but not to the benchmark.

In this version, Community came out on top, at 247% of modified Medicare, followed by IU Health at 258%. Ascension and Parkview tied at 275%, while Franciscan lagged at 283%.

“Since Modified Medicare is in the denominator of these percentages, removing the hospital-specific additional payments decreased the Medicare amounts, which, in turn, caused the percentages to increase,” the consultants reported.

They also analyzed the average commercial price, as a percentage of full Medicare, for three chunks of the commercially insured population: self-funded group health insurance, fully insured groups with insurance carrier plans and individual-level plans.

The individual market percent of Medicare was generally “much lower” than for either of the group markets. But much of the data couldn’t be mapped to a specific market segment, so results could “differ notably” if that information were available.

The report additionally compares the 2022 data to that year’s results in an influential RAND study, which didn’t consider practitioner and some outpatient services. The consultants adjusted for those and other differences, but couldn’t account for variations in data volume, sampling and collection time periods.

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