Several trends in medical billing have emerged in the wake of the No Surprises Act, which was first implemented in 2022, a recently released report by HHS found.
In its third report on analyzing the impact of the NSA, HHS found that out-of-network billing declines in some areas of healthcare, among other trends.
Here are four other takeaways from the report:
1. In 2022, the prevalence of out-of-network bills declined 15 % for emergency services and 11% for non-emergency services rendered at in-network facilities relative to 2021.
2. Compared to the baseline of 2019, there was a 24% decline in OON bills for emergency services at any facility and a 17% decline in OON bills for non-emergency services furnished at in-network facilities in 2022.
3. While OON payments remained higher than in-network payments for emergency services on average, the gap between OON payments and in-network payments narrowed over time, according to the report. For non-emergency services at in-network facilities, average OON payments fell below average in-network payments in 2022.
4. The report also includes an initial analysis of data on completed federal Independent Dispute Resolution disputes over OON payment rates between providers and private health plans and issuers. In 2023, providers won around 80% of IDR determinations over OON claims and around 85% of IDR determinations over OON air ambulance services.
