EXHIBIT 3.

Trends in commercial-to-Medicare hospital price ratios among 19 hospital referral regions (HRRs) with high ratios in 2012 and large ratio decreases in 2012–19

HRR name	2012	2019	Changea
Gulfport, MS	267%	158%	−109
Lafayette, IN	357	279	−78
Pueblo, CO	275	197	−78
Lawton, OK	220	167	−54
Casper, WY	246	193	−52
Hickory, NC	223	171	−52
St. Joseph, MI	233	182	−51
Bloomington, IL	254	207	−47
Cape Girardeau, MO	255	209	−46
Albany, GA	219	173	−46
South Bend, IN	254	211	−43
Longview, TX	264	224	−40
Contra Costa County, CA	314	273	−40
Munster, IN	215	185	−30
Reading, PA	206	177	−29
Omaha, NE	206	181	−25
Rapid City, SD	203	178	−25
Gary, IN	218	195	−23
Stockton, CA	234	215	−20

SOURCE Authors’ analysis of 2012–19 Healthcare Cost Report Information System data. NOTES Price ratio estimates reflect estimated commercial revenue-to-charge ratios divided by Medicare revenue-to-charge ratios. The commercial-to-Medicare hospital price ratios for these nineteen HRRs fall into the top quartile of ratios in 2012 and, among hospitals in the top quartile of ratios in 2012, the bottom quartile of ratio increases during the 2012–19 study period.

^aPercentage points.