A Better Way to End Surprise Medical Bills
Happily, there is a better way, an alternative approach that can end surprise bills without harming patients’ access to care. It consists of two elements:
- A market-based default payment. Instead of the median rate, the benchmark would be set at the current average rate paid to all similar providers in the area, or alternatively at the individual provider’s most recent contracted rate, if a contract has ever existed. Insurers would have to pay this default rate to out-of-network providers, up front.
- Baseball arbitration. If either party were dissatisfied with the default payment, they could take their dispute to so-called baseball arbitration, in which both parties would present a first-and-final offer and then a neutral arbitrator would choose one of the two offers without change.
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