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Expand chart
Data: Health Affairs; Chart: Axios Visuals

Four specialties that are often out-of-network — anesthesiologists, pathologists, radiologists and assistant surgeons — raise employer insurance spending by 3.4%, according to a new study in Health Affairs.

Why it matters: Surprise medical bills are not only unaffordable for the patients who receive them, but also inflate everyone else's premiums.

Between the lines: Providers are more likely to be out-of-network at for-profit hospitals and those located in concentrated markets, the study found.

  • These four specialties are providers that patients don't choose. They ultimately get paid several times more than they'd make from treating a Medicare patient.
  • In contrast, orthopedists performing knee surgeries — which patients do have the ability to choose — were paid 164% of Medicare rates, on average.
  • The study's authors argue that these four specialties can use the threat of billing patients directly to gain leverage in negotiations with insurers.

By the numbers: If the payment rates for these four specialties were reduced to 164% of Medicare, total physician spending among privately insured patients would be reduced by 13.4%, or $40 billion a year for people with employer coverage, the study found.

  • That's exactly why providers are fighting so hard against Congress' efforts to include a benchmark payment rate for out-of-network care as part of a surprise billing solution.
  • Whatever they spend in lobbying is, comparatively, chump change.

Go deeper:

Go deeper

Updated 24 mins ago - Politics & Policy

Gunman kills 8 people in shooting at FedEx facility in Indianapolis

A screenshot of the Indianapolis Metropolitan Police Department spokesperson Genae Cook during a news conference Friday morning. Photo: Indianapolis Metropolitan Police Department/Facebook

A gunman opened fire at a FedEx warehouse facility in Indianapolis late Thursday, killing at least eight people and wounding multiple others, authorities said.

Details: "The alleged shooter has taken his own life here at the scene," Indianapolis Metropolitan Police Department spokesperson Genae Cook said during a news conference early Friday.

Dems race to address, preempt stimulus fraud claims

Illustration: Aïda Amer/Axios

Biden officials are working to root out the systematic fraud in unemployment and Paycheck Protection Program claims that plagued the Trump administration’s efforts to boost the economy with coronavirus relief money, Gene Sperling told House committee chairmen privately this week.

Why it matters: President Biden just signed another $1.9 trillion of aid into law, with Sperling tapped to oversee its implementation. And the administration is asking Congress to approve another $2.2 trillion for the first phase of an infrastructure package.

8 hours ago - Politics & Policy

Scoop: Biden close to picking Nick Burns as China ambassador

Nicholas Burns. Photo: Alex Wong/Getty Images

Nicholas Burns, a career diplomat, is in the final stages of vetting to serve as President Biden’s ambassador to China, people familiar with the matter tell Axios.

Why it matters: Across the administration, there's a consensus the U.S. relationship with China will be the most critical — and consequential — of Biden's presidency. From trade to Taiwan, the stakes are high. Burns could be among the first batch of diplomatic nominees announced in the coming weeks.