Monday, August 19, 2019

CHART REVIEW Surprise Bills


Ryan Haygood, Health Care Policy Intern
Last week, the Weekly Checkup highlighted Wyoming’s proposal to end surprise air ambulance bills, which cost much more than other types of surprise bills and occur on 69 percent of all trips – a higher fraction than in any other medical setting. Taking surprise billing as a whole, however, air ambulances account for just 1 percent of all such bills. The lion’s share comes from the emergency room: While only about one-fifth of ER visits may incur surprise bills, the ER is responsible for two-thirds of them by volume. The potential annual volume of surprise bills sits at about 13 million, according to my evaluation of them across four medical settings, using estimates of surprisebilling incidence from 2014 to 2017. Each “potential” case involves a high risk of receiving a surprise bill from an out-of-network provider, although the extent of balance billing (i.e. charging the patient the listed out-of-network price) for these services is difficult to estimate. Also hard to measure is the incidence of potential surprise bills, with a study out this week finding double the rate of ER and inpatient surprise billing found by others. My estimate uses the lower of these figures and also excludes potential bills from out-of-network facilities and neonatal care, making it a lower-bound approximation.
Annual Potential Surprise Medical Bills

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