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Let’s end surprise billing without a Trojan Horse

Dr. Damian E. Caraballo discusses why using an Independent Dispute Resolution (IDR) is a better solution to Surprise Billing than Benchmarking.


"Insurers are using benchmark payments as a backdoor to an all-payer rate setting system they control. The health insurer PR-machine has capitalized on news articles that muddle emergency physician, hospital, and ambulance-transport billing in efforts to blame physicians for insurers’ network gaps. In a page out of the Big Pharma playbook, they have funded research through health care foundations which, not-coincidentally, publish pro-health insurer research. Sleight of hand is necessary for health insurers to compensate that while emergency physician salaries have risen 34.5% in the last 11 years, health insurance deductibles have risen 212 percent and premiums have increased 55% during the same time. The “Big 5” health insurance stock prices have risen somewhere from 400-880% in the past decade — no wonder 86% of consumers still blame health insurers for surprise bills. Meanwhile, emergency care in the U.S. only accounts for approximately 2% of health care spending, despite an estimated $4.2 billion in unfunded costs due to the Emergency Medical Treatment and Labor Act (EMTALA)."


Read the full article here.

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