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 surprise–billing 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.
Read more: https://www.americanactionforum.org/weekly-checkup/the-state-of-the-individual-health-insurance-market/#ixzz5x5DVoL2q
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