Protecting patients from surprise medical bills

Every year, millions of Americans are surprised to receive staggering medical bills after emergency or routine care from a provider they had no idea was outside of their insurers’ network—and often had no control in choosing. While one study in New York of large surprise bills for emergency care found that patients were billed over $3,500 on average, extreme cases can result in bills topping $250,000. Even careful planning may not always prevent patients from receiving surprise bills, as one in five non-elderly adults had received care at a hospital they thought was in-network but were still billed by a non-covered physician, whether an anesthesiologist, consulting surgeon, or other doctor. Yet, while stakeholders and policy experts agree this problem needs to be addressed, they disagree on how to tackle it.

On Thursday, October 13, the Schaeffer Initiative for Innovation in Health Policy released a white paper, “Solving Surprise Medical Bills,” and hosted an event bringing together representatives from health systems, insurers, and consumer advocacy groups, as well as policymakers and experts, to discuss solutions to comprehensively reduce surprise billing scenarios and resolve disputes over reimbursement for out-of-network care. The Schaeffer Initiative is a collaboration between the USC Schaeffer Center and the Brookings Center for Health Policy.

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