Tag: providers

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

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.

Adoption of Value-Based, Alternative Payment Models: Where Are We Today and Where Do We Go from Here?

Employer-sponsored health insurance costs had their highest annual increase since 2010 last year, and some experts are projecting additional health spending increases in 2022. Research has found that provider prices are the leading cause of high and rising health care spending in the US, and many policy experts have advocated for moving towards value-based, alternative payment models (APMs). CHIR’s Maanasa Kona takes a look how APMs have performed thus far and what the future may hold.

New Report Examines State Options for Oversight of Risk-Bearing Provider Organizations

Value-based payment models are promoted as a way to transform our health care system from one that rewards value rather than the volume of health care services delivered. These models require providers to accept the risk of financial losses should spending on patients in their care exceed targeted levels. A new brief from State Health and Value Strategies, authored by researchers at Bailit Health and CHIR, explores potential state approaches to oversight of provider organizations that accept financial risk.

As Health Market Consolidation Grows, So Do Prices

The Justice Department just stepped in to prevent two health insurance mergers. The health care market consolidation trend isn’t new – insurers and provider groups alike just keep getting larger. But what does it mean for consumers? CHIR’s legal intern Emma Chapman examines the evidence.

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.