Tag: independent dispute resolution

Independent Dispute Resolution Process 2024 Data: High Volume, More Provider Wins

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While the independent dispute resolution (IDR) process is intended to lead to fair outcomes for out-of-network payment, new analysis demonstrates unexpectedly high use of the IDR process, mostly by private-equity-backed providers that win often and win large. In their latest piece for Health Affairs Forefront, Jack Hoadley, Kennah Watts, and Zachary Baron illustrate trends in the IDR process and explore implications for costs.

No Surprises Act: Exploring the Impact on Employees, Employers and Costs

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On March 7, CHIR hosted the second event in a series of policy briefings on the future of employer-sponsored health insurance, sponsored by Arnold Ventures. This event, featuring remarks from Congressman “Bobby” Scott and a panel discussion moderated by Julie Appleby of KFF Health News, focused on the No Surprises Act’s impact on consumers and implementation challenges associated with the independent dispute resolution process.

Implementing the No Surprises Act: What We Know from Early Complaint Data

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The No Surprises Act (NSA) provides comprehensive protections from many of the most prevalent forms of surprise medical billing, and a new process for determining out-of-network provider reimbursement aims to control health care costs by limiting insurer payments for surprise bills. It remains to be seen if the new federal law—implemented only last year—will achieve these goals. Two recently released reports provide some of the first indicators of the NSA’s impact.

Surprise Billing: Volume Of Cases Using Independent Dispute Resolution Continues Higher Than Anticipated

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The No Surprises Act is largely working as intended to protect patients from unexpected medical bills. However, the rising number of Independent Dispute Resolution (IDR) cases is creating challenges for the health care system. In a post for Health Affairs Forefront, Jack Hoadley and Kevin Lucia evaluate the causes and implications of the increasing number of IDR cases.

Providers Challenge Payments In ‘No Surprises’ Act Dispute Resolution Process

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Under the No Surprises Act, consumers are held harmless beyond in-network cost sharing when they receive certain kinds of out-of-network care. In these scenarios, to determine the provider’s payment, payers and providers may enter independent dispute resolution (IDR). Recently, federal agencies released an initial report on the No Surprises Act’s IDR process. In a post for Health Affairs Forefront, CHIR experts Jack Hoadley and Kevin Lucia analyze the new report and discuss what it suggests about the No Surprises Act.

The No Surprises Act Final Rule: Implications for State Regulators

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The Biden administration has published its final rules governing the independent dispute resolution process outlined in the No Surprises Act. In a new Expert Perspective for the State Health & Value Strategies project, CHIR’s Jack Hoadley, Kevin Lucia, and JoAnn Volk review the rule and its implications for state regulators.

The opinions expressed here are solely those of the individual blog post authors and do not represent the views of Georgetown University, the Center on Health Insurance Reforms, any organization that the author is affiliated with, or the opinions of any other author who publishes on this blog.