Emergency Physicians Recover A Higher Share Of Charges From Out-Of-Network Care Than From In-Network Care

Surprise medical bills occur when a patient unexpectedly or involuntarily receives care from an out-of-network provider and is billed for the amount not covered by insurance. Past studies were unable to observe whether bills for such care were sent to patients and, if so, how much patients paid dire...

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Bibliographic Details
Published in:Health affairs (Millwood, Va.) Va.), 2021-04, Vol.40 (4), p.622-10
Main Authors: Biener, Adam I, Chartock, Benjamin L, Garmon, Christopher, Trish, Erin
Format: Article
Language:English
Subjects:
Calendars
Emergency medical care
Emergency medical services
Emergency services
Expenditures
Health care expenditures
Health insurance
Networks
Panel data
Patients
Personal health
Physicians
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Summary:Surprise medical bills occur when a patient unexpectedly or involuntarily receives care from an out-of-network provider and is billed for the amount not covered by insurance. Past studies were unable to observe whether bills for such care were sent to patients and, if so, how much patients paid directly to out-of-network providers. We used data from the Medical Expenditure Panel Survey to measure how much privately insured emergency patients paid when they likely received a surprise bill and how much physicians received in these situations. Physicians collected 65 percent of the charged amount for likely surprise bills compared with 52 percent for other cases. Patients who likely received a surprise out-of-network bill for emergency care paid physicians more than ten times as much as other emergency patients paid, on average.
ISSN:0278-2715
1544-5208
DOI:10.1377/hlthaff.2020.01471