Forward Of Print: Floor Ambulance Shock Billing Variations

The federal No Surprises Act, which took impact in 2022, protects customers who unknowingly use out-of-network well being care companies. Nonetheless, it fails to incorporate provisions for one notable supply of those payments—floor ambulance transports—probably due to some native governments’ fears that federal intervention would cut back their revenues from offering these companies. A brand new research, launched forward of print by Well being Affairs, builds on the present literature on this topic by evaluating floor ambulance costs and the magnitude of potential shock payments throughout public- and private-sector floor ambulance organizations. The authors reviewed private and non-private billing knowledge for nonelderly sufferers for 2014–17 and located that 28 p.c of commercially insured emergency floor transports resulted in a possible shock invoice. For nonemergency transports, shock payments occurred 26 p.c of the time. The research findings additionally illustrate notable variations throughout floor ambulance possession varieties in pricing and value sharing: In 2016–17, private-sector ambulances charged 38 p.c greater than public-sector ambulances, which resulted in 25 p.c increased value sharing for sufferers.

“The typical magnitude of the potential shock invoice throughout private-sector ambulance organizations was 52 p.c increased than from public-sector organizations for the commonest emergency transport,” the authors conclude. “[Our] findings spotlight substantial affected person legal responsibility and essential variations in pricing and billing patterns between public- and private-sector floor ambulance organizations.”