[reaperducer]

> The insurance companies only pay x% of any given item,

The hospitals negotiate those rates. If they're not happy with them, they need better negotiators.

[Thriptic]

Depends on what the market conditions are. If there is a lot of competition from hospitals then the payer may just refuse to include the hospital in network if they aren't willing to play ball, meaning they lose all the prospective business.