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Private equity firms don't just own physician firms and air ambulances that would be most affected by eradicating surprise bills. They also hold stakes in the companies that help health insurers determine what they should pay for out-of-network care.

Why it matters: Private equity has its footprint all throughout health care, but these financial firms especially have a lot on the line in Congress.

By the numbers: Seven major companies — CareCentrix, MedRisk, MultiPlan, naviHealth, One Call, Paradigm and Zelis — are hired by insurers to handle "health care cost containment," which includes things like bill editing and renegotiating out-of-network claims, according to Moody's Investors Service. 

  • Private equity owns a slice of each, and Moody's anticipates the aggregate annual revenue of these companies will reach $8 billion by 2020.
  • Two of those companies, MultiPlan and Zelis, are most directly involved with out-of-network claims and have the most to lose from any changes.

The big picture: Everything hinges on Congress' leading solution, which would use a benchmark rate to pay out-of-network providers.

  • "Should the new legislation set benchmark pricing, repricing claims would become de facto irrelevant, making part of these companies' business models obsolete," Moody's analysts wrote.

Yes, but: Because some of these companies already handle medical bill negotiating between providers and insurers, they "could play an active role in setting benchmark pricing for the industry and could even monetize their expertise," Moody's wrote.

  • "This would lessen the adverse impact of new legislation."

Go deeper: Private equity maximized profits while sick children were neglected

Go deeper

Bryan Walsh, author of Future
54 mins ago - Health

Schools face an uphill battle to reopen during the pandemic

Illustration: Aïda Amer/Axios

President Biden's plan to accelerate the reopening of K-8 schools faces major challenges from a still out-of-control pandemic and more contagious coronavirus variants.

Why it matters: The longer American kids miss in-person schooling, the further they fall behind. But the uncertain state of the science on the role young children play in the pandemic continues to complicate efforts to reopen schools.

Focus group: Former Trump voters say he should never hold office again

Illustration: Sarah Grillo/Axios

"Relief" is the top emotion some swing voters who used to support Donald Trump say they felt as they watched President Biden's swearing-in, followed by "hope."

Why it matters: For voters on the bubble between parties, this moment is less about excitement for Biden or liberal politics than exhaustion and disgust with Trump and a craving for national healing. Most said Trump should be prohibited from ever holding office again.

Updated 15 hours ago - Politics & Policy

Coronavirus dashboard

Illustration: Eniola Odetunde/Axios

  1. Health: Most vulnerable Americans aren't getting enough vaccine information — Fauci says Trump administration's lack of facts on COVID "very likely" cost lives.
  2. Politics: Biden unveils "wartime" COVID strategyBiden's COVID-19 bubble.
  3. Vaccine: Florida requiring proof of residency to get vaccine — CDC extends interval between vaccine doses for exceptional cases.
  4. World: Hong Kong to put tens of thousands on lockdown as cases surge.
  5. Sports: 2021 Tokyo Olympics hang in the balance.
  6. 🎧 Podcast: Carbon Health's CEO on unsticking the vaccine bottleneck.