Most patients assume their care will be covered by insurance as long as they go to an in-network hospital. But this is not the case if they’re treated by an out-of-network physician. Patients in this situation can end up with surprise medical bills for tens of thousands of dollars.
No easy fix
Lawmakers are currently trying to solve this problem. Even in a deeply divided congress, everyone agrees that patients should not face surprise medical bills. What they can’t agree on is an appropriate solution.
Under the current bill, a default price would be set on medical bills under $750. Bills exceeding that amount would go to arbitration. Hospitals and physicians are worried that default payment rates will decrease the likelihood that they will be compensated fairly for the services they provide.
The ripple effect
As congress debates proposed solutions to the problem of surprise medical bills, more and more doctors are becoming concerned about the long-term stability of their income. In search of stability, they are likely to turn their attention to their call pay arrangements.
History teaches us that when reimbursements go down, call pay goes up. The reimbursement reductions that occurred after the passage of EMTALA resulted in an onslaught of physician demands for increased call pay. Many hospitals felt they had no choice but to give in to these demands in order to secure call coverage. This turned call pay into a crushing financial burden for many healthcare organizations, and it’s still a top concern today.
Now that physicians feel that their income is once again threatened by proposed legislation, hospitals could see another onslaught of demands for increased call pay.
Preparing for the second wave
MaxWorth’s Call Pay Solution was designed to help hospitals manage their call pay budgets. A departure from the single-specialty-negotiation approach that has divided so many medical staffs, the program establishes a fairness standard for an organization’s call pay rates. It also increases the value of call pay by giving physicians the opportunity to invest the compensation on a pre-tax basis. To ensure the long-term sustainability of the program, hospitals are given the opportunity to recoup a portion of their call pay expenditure.
To learn more about the program, download our white paper, The Call Pay Solution: Stabilizing budgets with a fair and sustainable approach.
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