Policymakers Overlook a Major Cost Driver

KarenIgnagniAHIP President & CEO – Karen Ignagni

Some physicians who don’t participate in health insurance networks are charging patients 10 times the Medicare reimbursement for the same service in the same geographic area. In some cases, they charge nearly 100 times more, according to a report from America’s Health Insurance Plans (AHIP).

For example, in New York, a physician billed a patient $115,625 for lumbar spinal fusion, which is 62 times the Medicare fee of $1,867. Similar examples were found in all 30 states and there are many examples of even higher variations in charges. The report is based on data gathered from Dyckman & Associates

AHIP says that public policy discussions focus how much insurers pay for these services while ignoring what out-of-network physicians are charging patients. AHIP wants policymakers to look at how these charges compare to in-network fees as well as fees charged for similar services in other countries.

AHIP President and CEO Karen Ignagni notes that consumers who get services from in-network providers usually have lower cost sharing, which has saved billions of dollars in out-of-pocket costs and premiums over the decades. For more information, visit www.ahip.org.

Last Updated 05/25/2022

Arch Apple Financial Services | Individual & Family Health Plans, Affordable Care California, Group Medical Insurance, California Health Insurance Exchange Marketplace, Medicare Supplements, HMO & PPO Health Care Plans, Long Term Care & Disability Insurance, Life Insurance, Dental Insurance, Vision Insurance, Employee Benefits, Affordable Care Act Assistance, Health Benefits Exchange, Buy Health Insurance, Health Care Reform Plans, Insurance Agency, Westminster, Costa Mesa, Huntington Beach, Fountain Valley, Irvine, Santa Ana, Tustin, Aliso Viejo, Laguna Hills, Laguna Beach, Laguna Woods, Long Beach, Orange, Tustin Foothills, Seal Beach, Anaheim, Newport Beach, Yorba Linda, Placentia, Brea, La Habra, Orange County CA

12312 Pentagon Street - Garden Grove, CA 92841-3327 - Tel: 714.638.0853 - 800.731.2590
Copyright @ 2015 - Website Design and Search Engine Optimization by Blitz Mogul