In-network care rose after No Surprises Act: 5 things to know

The percentage of patients receiving in-network care has risen since the implementation of the No Surprises Act, according to a Feb. 20 report from FAIR Health. 

For the report, FAIR Health — a healthcare data analytics and consumer education organization — analyzed in-network and out-of-network utilization and pricing from 2019 to 2023 from its database of private healthcare claims records. That period includes the first two years after the No Surprise Act's implementation, which took place Jan. 1, 2022. 

 FAIR's study focused on professional services in facility settings, particularly in four specialities that it said have been frequently associated with surprise bills: anesthesia, emergency medicine, pathology and radiology. 

 Five things to know:

 1. In-network percentages increase across all specialities from the first quarter of 2019 to the third quarter of 2023 nationally and across all regions, according to the report. 

 2. During that period, in-network care as a percentage of all claim lines increased nationally, from 84.1% to 90%. Regionally, the increase varied from 4.8% in the Northeast to 8.3% in the Midwest and South. 

 3. FAIR said there was a "relatively sharp increase" in in-network percentages nationally (2.3%) from the fourth quarter of 2021 to the first quarter of 2022, the time when the No Surprises Act went into effect. 

 4. Narrowing the focus to the four specialties of interest, in-network care increased 4.7% from the first quarter of 2019 to the third quarter of 2023, according to the report. 

 5. Of the specialties of interest, emergency medicine had the greatest increase (13.2%) over that period. Pathology had the smallest (0.6%). 

 Read the full report here

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