As we wrap up 2021 and prepare ourselves for 2022, it’s fun to look forward and think about what may surprise us in 2022. In a really ironic way, I think one thing that is likely to surprise healthcare most in 2022 is the Surprise Billing regulations.
I was recently in Philadelphia visiting with Edward Bukstel and he said the same thing “The Surprise Billing regulation is going to surprise a lot of providers.”
At the end of the day, the surprise billing legislation is basically requiring healthcare organizations to not pay high out-of-network billing costs associated with emergency services. Plus, they must inform the patient of the potentially high costs they are incurring. However, for the most part the act essentially means that patients don’t need to worry about in-network or out-of-network.
What impact this will have on healthcare organizations and payers is a hotly disputed topic. Plus, it likely depends a lot on the patient population of the organization. We’re going to find out how many were relying on these high cost out of network bills and which ones weren’t. Understanding this is going to be an important step for most healthcare organizations.
I personally never worry about the payers, because they always win in these types of things. They can always raise premiums to make up for any of these changes. Although, some argue that these changes will actually allow payers to lower premiums. I can’t remember a payer ever lowering my premium, but I guess in theory it’s possible.
I’ll admit that I’m a bit of a novice on this topic. However, I think that’s also true for many healthcare organizations that don’t know how much “surprise billing” they’ve been doing either. My prediction is that in 2022, we’re all going to become much more informed on surprise billing and what it’s been doing for our organization. The real question is whether we’re going to be proactive in our efforts to learn or whether we’re going to wait for the surprise drop in revenue to then take the time to figure it out.
How are you and your organization approaching surprise billing? Are there any tools you’re using to assess how this will impact your organization?