Feb 13, 2020 - Health

How doctors have shaped the fight around surprise medical bills

Doctors' extensive lobbying on surprise medical bills is partly to blame for Congress' inaction on the issue, reports Kaiser Health News.

Why it matters: "As Congress begins its 2020 legislative session, there is evidence the doctors' message has been received: The bills with the most momentum are making more and more concessions to physicians."

The big picture: Many of the doctors involved in the surprise billing fight are employed by private equity-backed companies.

  • Doctors' voices have a distinct power compared to other industry lobbyists, as they're the ones providing care to patients.
  • Their message to lawmakers, one doctor told Rachana, is that "we just want to be paid a fair amount for the services rendered."

Reality check: Study after study has shown that the doctors that tend to send the most surprise bills also get paid more than other specialties.

  • One study found that four specialties that are often out-of-network raise employer insurance spending by 3.4%.
  • These other specialties — the ones that don't tend to be paid private insurance rates multiple times the amount that Medicare pays — somehow manage to get by.
  • And the relationship to high payment rates and surprise billing isn't random. Researchers say that the potential of surprise bills gives doctors greater negotiating leverage against insurers. One major physician staffing firm admitted as much to lawmakers last year.

Go deeper: Congress remains gridlocked on surprise medical bills

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