Solving surprise medical bills. Good overview by Brookings Institution (but does not address the common situation where MDs ask but cannot gain access to networks)

Solving surprise medical bills

5) Encourage hospitals to increase network participation by key physician specialists.

"Regulators could question whether health plan subscribers have adequate access at hospitals that lack sufficient network participation by key hospital-based specialists. This approach needs to be taken with caution however, because hospitals might have to make large financial commitments to such specialists and pass this on to insurers in higher rates for hospitals, costs ultimately borne by consumers through higher premiums. To temper this problem, regulators could use antitrust authority more actively to determine whether market power is being used inappropriately when most hospital specialists refuse to join networks."








Mark Hall, Paul Ginsburg, Steven M. Lieberman, Loren Adler, Caitlin Brandt, and Margaret DarlingThursday, October 13, 2016