James Rickert, M. Doctors across specialties will quickly follow emergency physicians, radiologists, and anesthesiologists, who have made surprise billing a staple of their business models — only now the bills will no longer be a surprise, and insurers will be legally obliged to pay them. Benchmarking out-of-network prices, on the other hand, will build on one of the few market dynamics working in America today to add both value and quality to medical care. James, when was the last time you ran a business and had to worry about paying the bills to keep the doors open, patients cared for, and your employees secure? Hint: it starts with….
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Using this approach, Congress would set a benchmark for out-of-network rates as a percentage of the current Medicare rate or prevailing in-network rate.
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Comment Please enter a comment. Asking Congress to have CBO set benchmarks, especially those controlled by insurance companies, is dangerous and short sighted.
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If Congress passes a flawed solution to surprise medical bills that contains incentives for out-of-network care, it will eviscerate insurance.
Proper benchmarking can address these problems. If Congress passes a flawed solution to surprise medical bills that contains incentives for out-of-network care, it will eviscerate insurance networks.
The average award — near the 80th percentile of physician billings — will ensure that it is almost always more profitable for a physician to be out of network than in it. Benchmarking out-of-network prices, on the other hand, will build on one of the few market dynamics working in America today to add both value and quality to medical care.
Solve surprise medical bills with benchmarking, not arbitration STAT
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