The Latest Research, Commentary, And News From Health Affairs
Wednesday, April 7, 2021
Dear John,
Roughly one in five emergency department visits involve an out-of-network provider, leaving many patients vulnerable to surprise medical bills. A new paper explores the costs to patients and benefits for physicians.
Patients Pay Ten Times More For Emergency Care If It’s Out-Of-Network
Surprise medical bills can occur when a patient with private health insurance unexpectedly or involuntarily receives care from an out-of-network provider and is billed for the uncovered portion. Patients using the emergency department are particularly susceptible to surprise bills because doctors aren’t always in the same networks as the hospitals where they practice.
In a new Health Affairs article in the April issue, Adam Biener
and his colleagues measured how much privately insured emergency department patients paid when they received a surprise bill and how much physicians received in these situations. They
analyzed survey data and found that patients who likely received a surprise out-of-network bill for emergency care paid physicians more than ten times as much as other emergency patients paid. In addition, physicians on average collected a larger share of the total bill for out-of-network care than for in-network care.
These findings have serious implications for both payers and hospitals, as reflected by the bipartisan effort in Congress to end most instances of surprise
billing. In a recent blog post, Jack Hoadley, Katie Keith, and Kevin Lucia unpacked the No Surprises Act, which was included in the omnibus spending bill that President Trump signed in
December.
The Health Affairs Podcast Fellowship is an exciting new program for US-based applicants. The program is intended for early- or mid-early–stage career individuals with an interest in health policy and storytelling.
The program is intended to
support applicants who have an audio project in mind to inform and educate the public. Applicants should have a working knowledge of the topic and an idea of what’s needed to complete their project (interviews, data, field recordings, etc.).
Each fellow will produce a podcast series of at least four episodes using interviews, background briefs, public data, Health Affairs research, and other materials to tell the story.
Candidates are expected to be US-based print or radio journalists, freelance storytellers, solo-preneurs, or academics. The fellowship is designed to enable fellows to work independently over a five-month period (June to October) to produce a podcast series/story of at least four episodes, which Health Affairs will publish soon after.
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