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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

First look: Mayors press Biden on immigration

Illustration: Sarah Grillo/Axios

A coalition of nearly 200 mayors and county executives is challenging Joe Biden and the incoming Congress to adopt a progressive immigration agenda that would give everyone a pathway to citizenship.

Why it matters: The group's goals, set out in a white paper released today, seem to fall slightly to the left of what the president-elect plans to propose on Inauguration Day — though not far — and come at a time of intense national polarization over immigration.

Caitlin Owens, author of Vitals
5 mins ago - Health

Demand for coronavirus vaccines is outstripping supply

Illustration: Aïda Amer/Axios

Now that nearly half of the U.S. population could be eligible for coronavirus vaccines, America is facing the problem experts thought we’d have all along: demand for the vaccine is outstripping supply.

Why it matters: The Trump administration’s call for states to open up vaccine access to all Americans 65 and older and adults with pre-existing conditions may have helped massage out some bottlenecks in the distribution process, but it’s also led to a different kind of chaos.

Woman who allegedly stole laptop from Pelosi's office to sell to Russia is arrested

Photo: FBI

A woman accused of breaching the Capitol and planning to sell to Russia a laptop or hard drive she allegedly stole from Speaker Nancy Pelosi's office was arrested in Pennsylvania's Middle District Monday, the Department of Justice said.

Driving the news: Riley June Williams, 22, is charged with illegally entering the Capitol as well as violent entry and disorderly conduct. She has not been charged over the laptop allegation and the case remains under investigation, per the DOJ.