Surprise billing continues to garner significant media scrutiny. Stories of unexpected medical bills in the thousands of dollars exacerbate patient fear and frustration around health care affordability. Along with drug pricing, surprise billing has become a focal point for federal legislators and consumers alike. Federal efforts have focused on affordability and examining private equity’s investment in stalling surprise billing initiatives. This attention has spurred debate around potential government fixes at the federal level. At the same time, states continue to enact legislation while providers and insurers (and their respective lobbyists) square off and patients are stuck in the middle.
Advisory Board examined the three major factors driving surprise billing and five key components of state surprise billing legislation. States’ experiences can prepare stakeholders for the expected effects of similar proposals at the federal level and inform lobbying efforts that align with organizational goals.