How hospitals source their ER physicians, surgeons and specialists like anesthesiologists and radiologists is the subject of a recent study from the Yale School of Public Health and School of Management. The study illustrates how patients choose a hospital that’s in-network only to learn that out-of-network doctors are working in “in-network” hospitals. Patients have an almost 1-in-4 chance that their ER doctor, who treats them is actually out-of-network, and they will receive a surprise medical bill.
This trend is tied to how hospitals are staffing their doctors. Instead of staffing positions with individual doctors, they are contracting with an outside physician group; therefore, individual doctors may not be in the same network as the hospital. The insurance company gets to pay less, and patients are stuck paying more. Plus, Yale found that many out-of-network physicians are paid 2.7 times more than in-network doctors–forcing you, and other patients to pay more for similar services.
KS&G believes this practice favors physicians and insurance companies and is unfavorable to patients. Even those who are diligent about reviewing network data cannot win and can face out-of-network doctors in the emergency room.
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