Examining evidence From New York & California
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Thursday, September 8, 2022 | The Latest Research, Commentary, And News
From Health Affairs
Dear John,
Don't miss this month's Journal Club event
on Thursday, September 15, when authors Mitchell Tang and Ateev Mehrotra
of Harvard University will discuss their paper on remote patient
monitoring.
Access to our Journal Club events is limited to Health Affairs Insiders
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Use discount code HAInsider10 to get $10 off your membership today.
State Surprise Billing Laws
In their September Health Affairs article, Aliza Gordon and coauthors
compare trends over time in provider charges for out-of-network care
during surprise bill scenarios in New York and California.
Both states both have existing laws allowing arbitrators to consider
charges during payment disputes over surprise bills.
Studying medical claims data for commercial health plan members from
2011-2022, the authors find different outcomes in each state.
"In New York, provider charges increased for surprise bill scenarios
that arose from inpatient nonemergency hospitalizations after the
passage of a surprise billing law that uses an independent dispute
resolution process relying on charges to determine out-of-network
provider payments," Gordon and coauthors report.
In contrast, they find a decrease in provider charges for a similar set
of scenarios in California, where the law instead relies on a payment
standard tied to in-network prices to determine out-of-network payments
during surprise bill scenarios.
Read More
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Elsewhere At Health Affairs
Today in Health Affairs Forefront, Andrew Racine and Thomas Lee ask the
question
:
What accounts for the fact that Black populations have higher mortality
rates on a population basis but in-hospital case fatality rates at least
as good as that for Whites in these large hospital systems?
On the topic of COVID-19, Angela K. Shen and Jason L. Schwartz assess
the future of adult vaccination programs
as the US transitions to a mixed public-private model for the purchase,
delivery, and coverage of COVID-19 vaccines.
If you like the work we publish on Forefront and our podcasts, you can
show your support by becoming a Health Affairs Insider
,
and as an added bonus, you'll get a free gift for joining.
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Daily Digest
Provider Charges And State Surprise Billing Laws: Evidence From New York
And California
Aliza S. Gordon et al.
For Patients Hospitalized With COVID-19, Mortality Does Not Appear To
Vary By Race
Andrew D. Racine and Thomas H. Lee
COVID-19 From Pandemic To Endemic: Strengthening Routine Adult
Vaccination Programs
Angela K. Shen and Jason L. Schwartz
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About Health Affairs
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, and Health Affairs Sunday
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