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New York's surprise billing law — which providers hope will become the model for a national solution — has resulted in providers receiving some very high payments, according to a new analysis by the USC-Brookings Schaeffer Initiative for Health Policy.

Why it matters: Surprise medical bills impact two groups of people: The patients directly responsible for paying them, and the rest of us, who pay higher premiums as a result of their existence.

  • A solution resulting in higher provider reimbursements would still protect patients from enormous surprise bills, but it could raise health care costs and thus premiums.

Details: New York's law resolves payment disputes between insurers and providers — the heart of the surprise billing debate — by using an arbitration process.

  • State guidance says that arbiters should consider the 80th percentile of billed charges, or list prices. The problem is that these charges tend to be much higher than the negotiated rates that insurers pay for in-network care.
  • A New York Department of Financial Services report found that the average payment amount decided through arbitration is 8% higher than the 80th percentile of charges — a victory for providers.
  • This, in turn, is likely to raise physicians' leverage with insurers when negotiating payment rates.

Yes, but: The state's report says the law has saved consumers an estimated $400 million, "but there is no supporting evidence provided and the actual data released in the report strongly suggests that the opposite is true," the USC-Brookings analysis argues.

Go deeper: Hospitals' dog in the surprise billing fight

Go deeper

11 mins ago - Health

Pfizer says COVID vaccine over 90% effective in kids

A health care worker preparing a Pfizer-BioNTech coronavirus vaccine dose in New York City on Oct. 21. Photo: Michael M. Santiago/Getty Images

Pfizer-BioNTech's COVID-19 vaccine was more than 90% effective at protecting children between the ages of 5 and 11 from symptomatic infections from the virus, according to a study released by the Food and Drug Administration Friday.

Why it matters: Pfizer is seeking an emergency use authorization to vaccinate children — one of the last groups of Americans still largely ineligible to receive a coronavirus vaccine.

Changing the inflation conversation

Illustration: Annelise Capossela/Axios

Inflation looks like it’ll run hot for longer than plenty of smart people thought it would. The conversation over just how much more Americans will have to pay for their stuff has taken on a new intensity, as supply problems show few signs of fading.

Why it matters: The rate of price growth has remained consistently strong in recent months — a time that some thought would bring cooling prices after an initial reopening spike. What goes on with prices will influence the decisions made by Congress, the Biden Administration, and the Federal Reserve.

The biggest headline from Biden's town hall

President Biden greets attendees during a commercial break in Baltimore last night. Photo: Nicholas Kamm/AFP via Getty Images

What matters from President Biden's town hall with CNN's Anderson Cooper at Baltimore Center Stage on Thursday, via Axios night owl Hans Nichols:

The biggest headline: Biden is jettisoning the corporate tax increases that White House officials have insisted, for the past 10 months, are wildly popular across the country. He admitted he doesn't have the votes.