The effects of California's surprise medical billing law
Illustration: Sarah Grillo/Axios
California's law prohibiting surprise billing has led to an increase in care delivered by in-network providers, according to a new analysis by the USC-Brookings Schaeffer on Health Policy initiative.
The big picture: The leading federal surprise billing solution is similar to the California bill in that it creates a benchmark payment rate for out-of-network care. Providers have lobbied fiercely against the approach.
- But while provider groups have warned that such a policy would lead to doctor shortages and threaten patients' access to care, that's not borne out in the data, according to USC-Brookings.
By the numbers: There was a 17% decrease in the share of out-of-network services delivered by the affected provider specialties after the California law took effect.
- Conversely, the share of in-network services increased from 79.1% to 82.6%.
Yes, but: What the approach likely does do is reduce providers' bargaining leverage with insurers, leading to lower overall payment rates.
- As the NYT succinctly puts it, "Some doctors may be hurting from a pay cut, but that doesn't seem to be hurting patients."
Go deeper: We all pay for surprise emergency room bills