21. The No Surprises Act Will Drive Costs Upward

While the No Surprises Act is saving patients from huge bills, the badly crafted bill will drive healthcare costs up dramatically over time.

About The Podcast:

Millions of Americans feel confused and frustrated in their search for quality healthcare coverage.

Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change.

Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcast offers accessible, incisive deep dives on the most pressing issues and events in American healthcare.

Marc seeks to help Americans become wiser consumers and navigate the healthcare maze with more confidence and certainty through the Healthcare Labyrinth website and his book of the same name.

Marc is an unconventional Republican who believes that affordable universal access is a wise and prudent investment. He recommends common-sense solutions to reform American healthcare.

Tune in every week as Marc examines the latest developments in the space, offering analysis, insights, and predictions on the changing state of healthcare in America.

About The Episode:

On this episode, Marc discusses the No Surprises Act.  It is now over two years old.  It is clearly saving patients from horrendous out-of-network surprise bills, but data seem to show it will drive up healthcare costs considerably.  It is badly crafted, badly analyzed by the CBO, and was influenced by politics on Capitol Hill.

Key Takeaways:  

The No Surprises Act does not stop every surprise bill so people have to watch and plan best they can.

The No Surprises Act stops patients from paying exorbitant out-of-network bills when there are emergencies and when there are planned in-network facility procedures.

The bill was poorly implemented, leading to huge backlogs for cases.

The CBO totally misjudged the impact of the bill.

A new study shows that providers are winning 75% of awards at payment awards that are roughly consistent with billed charges before the law went into effect.

These costs were not in the premium structure and will increase premiums, increase in-network rates over time, and increase costs to the system.

Private equity firms are taking advantage of the act by filing the lion’s share of cases.  They drive up price to drive margin – with no benefit to healthcare.

The No Surprise Act has to be overhauled to safeguard patients but also to rationalize the payments.

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