Column: Baseball-style arbitration of fees can end surprise medical bills


Commentary by Dr. Alex Choi

I have been a physician for 18 years and have been president of the largest anesthesia practice in Indiana for eight years. In that time, I’ve seen firsthand the heavy toll that surprise medical bills can take on patients. The good news is that Congress is acting to relieve patients of surprise bills and Sen. Mike Braun (R-Ind.) sits on the committee that will be hearing proposed legislation.

Surprise billing occurs when patients receive large bills from their insurers after receiving unplanned medical care from providers outside their network. The result is that, instead of focusing on their recovery, Hoosiers must worry about how to pay bills that are far beyond their means.

I applaud Congress for considering legislation to take the burden of these bills off of patients. However, a legislative solution could still hurt patients. To protect vulnerable Hoosiers from harm, legislation must include an independent dispute-resolution process.

IDR is a better way of setting provider payment rates than benchmarking, which would let the government decide what physicians would be paid. Benchmarking would allow the government to manipulate the open market and significantly undervalue physicians’ roles, which could hasten provider consolidation and reduce access to care. IDR works because it encourages medical providers and insurance companies to work together to reach a fair solution.

In New York, the state has implemented an IDR process called “baseball-style” arbitration. In this process, a third party chooses one appropriate payment from two suggestions offered by the insurer and the physician. Unlike other forms of arbitration, this is very quick, efficient and cost-effective. The IDR process ensures that providers are adequately compensated, so that they can afford to continue to care for patients in their communities.

I call on Braun to make sure that the only legislation that passes Congress includes an IDR solution. It is in the best interest of Indiana patients that Braun protect us from government overreach and protect our physicians from the inevitable cutbacks that benchmarking fees would bring.

Alexander Choi, M.D., MPH, is an anesthesiologist and president of Anesthesia Consultants of Indianapolis, the largest physician practice in Indiana with more than 100 anesthesiologists. He also is the immediate past president of the Indiana Society of Anesthesiologists and is active as the Vice Speaker of the House for the Indiana State Medical Association. He is a candidate for Zionsville Town Council At-Large.

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