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they're the ones that identify the exact culprit

Response: As previously discussed in this final rule with comment period, we believe the payer-specific negotiated charges would better reflect relative resources used because the rates that hospitals negotiate with MAOs capture the relative resource use to provide services to patients in order to maximize profits (or, in the case of not-for-profit hospitals, net income), subject to market constraints and conditions (supply and demand, community benefit requirements, etc.)

women (15-44 years), National Health and Nutrition Examination Survey 2005-2010

Doctors use them when metformin doesnt work or is unsuitable for patients

University of IowaEric Hoffman*, Janice Cook-Granroth