Private Equity Firms Exploit Patients
Seeking Emergency Care
The growing presence of private equity-backed providers is becoming an all too common influence in the health system – and one of the leading drivers behind egregious surprise medical bills that bankrupt families across the country. Learn more about how private equity firms exploit the market at the expense of patients – and why surprise medical billing reforms need to address the soaring cost of these bills.
Guidehouse as an IDR Entity Would Be Akin to Letting the ‘Fox Guard the Hen House’
The Coalition Against Surprise Medical Billing (CASMB)—representing leading employer groups, unions and health insurance providers—sent a letter to the Trump administration strongly opposing Guidehouse, Inc.’s petition to become a Certified Independent Dispute...
Flawed & Costly Arbitration Process Adding $1 Billion in Additional Costs
While the No Surprises Act was intended to curb the worst of unfair billing practices from out-of-network providers and certain private equity firms, a recent analysis from the Niskanen Center highlights how misuse of the arbitration process is contributing to $1...
ICYMI: Arbitration Roulette—When Outcomes Depend on the Arbitrator, Not the Facts
A new Health Affairs article published by researchers at Georgetown University’s Center on Health Insurance Reforms and released as a companion article to an earlier analysis, highlights alarming inconsistencies in how arbitrators are resolving payment disputes under...
ICYMI: Private Equity-Backed Providers and Profit-Enhancing Middlemen Have Made Manipulating the IDR Process a Business Model
Certain health care providers—particularly large, private equity-backed groups—are increasingly dominating the federal Independent Dispute Resolution (IDR) process established under the No Surprises Act, according to new data from the Centers for Medicare &...
CASMB Urges Trump Administration To Fix Flawed Arbitration Process
Before the passage of the No Surprises Act, too many patients experienced the costly burden of surprise medical bills. President Trump signed this landmark law in December 2020, and since it took effect in January 2022, it is preventing approximately 1 million...
ICYMI: New Analysis from Brookings Underscores How Private Equity Is Overwhelming Arbitration
Certain private equity-backed providers are flooding the federal arbitration process with thousands of frivolous and ineligible claims, according to a new analysis from Brookings Institution researchers published in Health Affairs. The latest assessment confirms that...
Employers, Health Plans Oppose Legislation to Make Arbitration More Costly for Consumers
While the No Surprises Act took a critical step in banning unfair, egregious surprise medical bills, certain private equity-backed providers continue to abuse and misuse the law’s arbitration process (also known as independent dispute resolution, or IDR) as a “back...
Four Provider Organizations Are Abusing and Misusing Arbitration. Employers, Patients, and Families are Paying the Price
Prior to the passage of the No Surprises Act, certain private equity-backed health care providers designed an entire business model around strategically exiting health plans’ networks as a way to maximize out-of-network reimbursements at the expense of patients,...
ICYMI: How Private Equity Is Gaming the No Surprises Act
Researchers at Georgetown University’s Center on Health Insurance Reform recently analyzed new data from the Centers for Medicare & Medicaid Services (CMS) detailing arbitration outcomes from all of 2023 under the No Surprises Act. While the law has been effective...
Four Key Takeaways from the Latest No Surprises Act Data
Researchers from the Brookings Institution recently analyzed the latest data from the Centers for Medicare & Medicaid Services (CMS) detailing arbitration outcomes under the No Surprises Act (NSA). The analysis reviews Q3 and Q4 2024 outcomes as an update to their...