Adam I. Biener (
Benjamin L. Chartock is a PhD student in the Health Care Management Department at the Wharton School and an associate fellow at the Leonard Davis Institute of Health Economics, both at the University of Pennsylvania, in Philadelphia, Pennsylvania.
Health Aff (Millwood). 2021 Apr;40(4):622-628. doi: 10.1377/hlthaff.2020.01471.
Surprise medical bills occur when a patient unexpectedly or involuntarily receives care from an out-of-network provider and is billed for the amount not covered by insurance. Past studies were unable to observe whether bills for such care were sent to patients and, if so, how much patients paid directly to out-of-network providers. We used data from the Medical Expenditure Panel Survey to measure how much privately insured emergency patients paid when they likely received a surprise bill and how much physicians received in these situations. Physicians collected 65 percent of the charged amount for likely surprise bills compared with 52 percent for other cases. Patients who likely received a surprise out-of-network bill for emergency care paid physicians more than ten times as much as other emergency patients paid, on average.
当患者意外或非自愿地接受了网络外提供者的医疗服务,并收到了保险未覆盖的费用账单时,就会出现意外医疗费用账单。过去的研究无法观察到是否向患者发送了此类医疗服务的账单,如果发送了,患者直接向网络外提供者支付了多少费用。我们使用来自医疗支出面板调查的数据来衡量私人保险的急诊患者在可能收到意外账单时支付了多少费用,以及医生在这些情况下收到了多少费用。与其他情况相比,医生收取了可能的意外账单金额的 65%,而收取了其他情况的 52%。接受急诊网络外账单的患者平均支付给医生的费用是其他急诊患者的十倍以上。