To the editor,
Williamson County Commissioner Gregg Lawrence is spot-on in his piece (“Alexander’s median pricing benchmark is best solution to address surprise medical bills”).
Surprise medical billing is a practice that leaves many patients on the hook for thousands of dollars in unexpected medical bills — even if they’re visiting an in-network hospital.
The stats are staggering. One in five in-network emergency room visits result in a surprise medical bill. It’s important to note that many of these surprise bills are coming from doctors who treat patients at in-network hospitals, but the doctors themselves do not happen to be in network.
About 5% of physicians tend to purposely stay out of the insurance networks in order to charge out-of-network fees that result in surprise medical bills with outrageous prices. Many of these physicians are backed by Wall Street venture capital funds that are abusing the system and getting way overpaid.
Under Sen. Lamar Alexander’s legislation, providers who do not join the network at the hospital would be reimbursed at the median, or middle, amount set in each local market. The Congressional Budget Office estimates that this approach would save taxpayers approximately $25 billion over the next decade.
The median pricing model is the correct solution for a truly economically fair market rate that protects patients and ensures equitable payment to providers without government overreach or lengthy and expensive attorney-driven arbitration.
(Patsy Writesman is a nationally recognized health care speaker, consultant and owner of ManageHealthCareCosts.com.)