Association Between ‘Balance Billing’ Legislation and Anesthesia Payments in California: A Retrospective Analysis
Anesthesiology, July 2023
A California law passed in 2017 prohibited “surprise” billing of patients for balances not covered by insurance – specifically, for patients in fully insured health plans receiving non-emergency care from out-of-network providers working at in-network facilities. The law’s impact on the cost for anesthesiology services provided in network proved contentious, yet was not initially studied fully.
To address that issue, Analysis Group Managing Principal Lee Heavner, affiliates Laurence C. Baker and Eric Sun, and Anjali Dixit of Stanford University coauthored a study evaluating the law’s impact on anesthesia care cost. The authors analyzed average quarterly county-level payments that were derived from a database of approximately 4.6 million claims spanning the period from 2013 through 2020 for commercially insured patients. The results suggested that the California law’s implementation was associated with a statistically significant decline in payments for out-of-network anesthesia care and an increase in payments for in-network anesthesia care. The analysis did not find a statistically significant change in the portion of claims occurring out of network.
The study, “Association Between ‘Balance Billing’ Legislation and Anesthesia Payments in California: A Retrospective Analysis,” was published in the July 2023 issue of Anesthesiology.
Authors
Heavner DL, Dixit A, Baker L, Sun E