surprises from no surprises
Banning surprise medical bills is raising other costs
The good news first: The federal government's surprise medical bill ban is protecting patients from giant costs. But it's raising costs elsewhere, and insurers aren't happy.
The Biden administration's new progress report on the process for arbitrating disagreements between insurance companies and providers shows that in over 80% of payment disputes, the arbiter settled on an amount that was more than the median in-network rate for that service, Tara Bannow reports. In short, insurers were ordered to pay more to an out-of-network provider than they'd pay to a contracted one. Plus, the sheer volume of disputes means health officials are devoting a ton of time to the task, throwing into question how much this will save federal dollars in the long-run.
The report has prompted quick criticisms from policy analysts who have warned that the system in place would lead to unintended consequences playing out now. Dive into the issue with Tara.
in the ma world
Medicare Advantage hits 33 million enrollees
Roughly 33.4 million people were enrolled in a Medicare Advantage plan as the calendar flipped to 2024 — another year of steady, albeit slower, growth for the taxpayer-funded program, Bob Herman writes.
The data reinforce how America's Medicare program continues to shift toward a more privatized version that has not saved any money for taxpayers, has been linked to inappropriate coding practices, and has restricted care for older and vulnerable patients. And even though the federal government made several changes to Medicare Advantage for 2024 — changes that were vehemently opposed by the health insurance industry — the program's growth has not been stunted, nor did insurers dramatically slash their offerings.
But there are some caveats to the data, experts tell Bob. More on understanding the MA trends.
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