Benchmark rates not the answer to surprise billing, University of Maryland health official says

In an opinion piece published by The Washington Post, a board member of Baltimore-based University of Maryland Health System argues that a benchmarking approach is not the right federal legislative solution to address surprise medical bills.

Rushern L. Baker III wrote that benchmarking, or tying physicians' out-of-network rates to insurance companies’ median in-network rates, "would have a devasting effect on healthcare throughout the metropolitan region."

Using already highly discounted rates as a payment standard for out-of-network providers would dramatically slash reimbursements to hospitals, emergency rooms and healthcare clinics, Mr. Baker said.

Those lower rates would in turn "lead to a loss of quality practitioners and healthcare staff, which would result in reduced patient access to care, and ultimately, higher prices," he predicted.

Mr. Baker said he wants an independent dispute resolution process, through which providers and insurers work out payment disputes, to be included in federal surprise-billing legislation.

Read the full piece here.


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