Out-of-Network
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Health Affairs Blog: Out-of-Network Spending: Why Growing Attention Is Focused On A Small Share Of Medical Spending
Tags: Out-of-Network
Read more: Health Affairs Blog: Out-of-Network Spending: Why Growing Attention Is Focused On A Small Share Of Medical SpendingIn HCCI’s publication in Health Affairs Blog, we examine the cost and utilization of out-of-network care in commercial claims. From the article: “People receiving surprise bills, sometimes totaling tens of thousands of dollars, have been frequently chronicled by high-profile media stories and in academic research over the past several years. Previous research from the Health Care Cost…
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Health Affairs: Out-Of-Network Spending Mostly Declined In Privately Insured Populations With A Few Notable Exceptions From 2008 To 2016
Tags: Out-of-NetworkRead more: Health Affairs: Out-Of-Network Spending Mostly Declined In Privately Insured Populations With A Few Notable Exceptions From 2008 To 2016In HCCI’s publication in Health Affairs, we examined out-of-network spending in the privately insured population. Abstract: “While out-of-network or potential “surprise” billing has garnered increasing attention, particularly in emergency department and inpatient settings, few national studies have examined out-of-network care overall or in other settings. We examined out-of-network spending and use among two large nationwide…
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How often do providers bill out of network?
Read more: How often do providers bill out of network?In recent analysis, we document extensive variation across states and metropolitan areas in the frequency of out-of-network visits among individuals with health insurance provided by an employer. These differences raise the question of whether individual providers bill out of network at dissimilar rates. To explore whether a small group of providers are responsible for most…
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How common is out-of-network billing?
Tags: Commercially Insured, Emergency Room, Geographic Variation, Mental Health and Substance Use, Out-of-Network, Surprise BillingRead more: How common is out-of-network billing?Congress is considering legislation to address “surprise bills”, which occur when a person visits an in-network facility, but receives services from a provider that is outside of their insurer’s network. Bills in both the House and Senate include provisions to determine a benchmark rate for out-of-network payments based on what in-network providers of the same…
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Comparing Average Rates for Select Anesthesiology, Emergency Medicine, and Radiology Services by Local Areas
Tags: Commercially Insured, Emergency Room, Geographic Variation, Medicare, Out-of-Network, Physician Spending
Read more: Comparing Average Rates for Select Anesthesiology, Emergency Medicine, and Radiology Services by Local AreasWhen a person unknowingly receives health care services from a provider that is outside of their insurer’s network, it gives rise to the potential for a “surprise bill”. Congress continues to consider legislation aimed at reducing the financial burden of “surprise bills” for patients. The approach approved by committees in both the House and Senate…
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Surprise out-of-network medical bills during in-network hospital admissions varied by state and medical specialty, 2016
Read more: Surprise out-of-network medical bills during in-network hospital admissions varied by state and medical specialty, 2016Out-of-network billing practices have increasingly garnered attention as individuals with commercial health insurance continue to experience “surprise billing.” A surprise medical bill commonly describes a charge to a patient for care delivered by an out-of-network (OON) professional who works within an in-network facility. We used the Health Care Cost Institute’s (HCCI) vast commercial claims database to…