February 13, 2020


In a new editor's commentary published in JAMA Health Forum as Congress holds hearings and votes on legislation to address surprise medical bills, Melinda Buntin, Ph.D., says it's time for Congress to pay attention.

Buntin, who serves as deputy editor of the new JAMA Health Forum online journal in addition to her position as Mike Curb professor of Health Policy and chair of the Department of Health Policy, writes in the commentary that new research published by the journal about surprise bills in elective surgical procedures, where patients can choose an in-network provider. In those cases, 20.5% of those procedures — by in-network providers at in-network facilities — produced an out-of-network bill. In some cases, the research found, the bills were thousands of dollars.

Buntin notes the research does not point to possible policy solutions, which Congress is currently mulling.

"Hopefully, a compromise will be reached between those in Congress who favor setting a benchmark rate for compensating out-of-network providers in these situations and those who favor arbitration between insurers and out-of-network providers," Buntin said, referring to the two primary policy suggestions in discussions now.

A policy solution is a topic of debate, but what's not is the effect on patients.

Read the full commentary here: https://jamanetwork.com/channels/health-forum/fullarticle/2761275

The referenced study can be found here: https://jamanetwork.com/journals/jama/fullarticle/2760735