Consumers have more information than ever before about the products they buy, but the healthcare sector has been slow to adopt the trend.
Brian Woods, MD, President of Clinical Services at NorthStar Anesthesia, spoke with Becker's about why the No Surprise Billing Act doesn't truly address the underlying issues in medical billing.
Note: These responses were lightly edited for clarity and length.
Question: What trends or issues in anesthesia are you following most closely right now?
Dr. Brian Woods: [One is] the No Surprise Billing Act. It's right in intent, but it puts medical providers in a difficult position to continue getting the market rate for the services they deliver. The main disconnect is that the mediator is authorized to use the price that the insurance company tells them is the median price as the "market price".
That is causing some large payers to literally cancel contracts that have been in network for a long time, simply because the rates might be high compared to the rest of the market. If they cancel the contract, the only recourse to get back in network is to come back to the negotiating table. But then the payer knows, 'Well, median rates are the market norm so we're going to start our negotiations at that point."