Patients are suffering from surprise bills, on average, one-in-five of emergency visits result in at least one out of network charge. That number cannot be allowed to grow. Surprise medical bills put families at financial risk and cause patients stress during times of recovery. Patients should be confident when they leave the emergency room that the worst is behind them. Congress must act; however, it should ensure it protects patients and the doctors who treat them. Right now, only one solution has put patients first — an Independent Dispute Resolution Process or IDR. So what is IDR and how has it helped patients?
This common-sense legislation protects patients from surprise billing. IDR allows an independent arbiter to decide what is fair when insurance companies and doctors do not have a previously negotiated agreement, so when patients inadvertently see an out of network provider, they won’t be stuck with the bill. In New York, where IDR has been implemented the longest, IDR has saved over $400 million in healthcare costs, out of network bills have declined, and premium growth remains flat, as do provider charges. This year, Texas implemented a similar law modeled after the success of New York’s landmark legislation.
Instead of going with what works, Congress is considering an untested proposals that would favor insurance companies over patients and doctors. Insurers want government protected pricing power over doctors’ services. By pushing a “median in-network rate” insurers will be able to drive down the median price due to a lack of transparency and absence of an independent databases of rates. Tell Congress to implement what works and act for patients and doctors, not the insurance companies.