The Department of Health and Human Services Office of the Assistant Secretary for Planning and Evaluation (ASPE) recently released the first annual report on the impact of the No Surprises Act (NSA) on health care markets.
The report identifies the factors the agency intends to monitor to evaluate the impact of the NSA on health care markets and provides an analysis of the state of these factors prior to implementation of the NSA for the purpose of creating a baseline for future analyses. These factors include: the implementation and impacts of state surprise billing laws already in effect; trends in market consolidation and concentration; the impact of market consolidation and concentration on prices, quality, and spending; and trends in out-of-network billing.
The report includes a number of notable findings related to out-of-network billing and health care consolidation. ASPE found that the trend in out-of-network billing — both in terms of the prevalence of out-of-network claims and the total amount associated with those claims — was already decreasing prior to the implementation of the NSA and that out-of-network billing is highly concentrated among a small percentage of physicians from certain specialties. With respect to consolidation, ASPE found that “since 2017, the number of changes in hospital ownership have fluctuated on a quarterly basis but do not seem to be subject to an increasing overall trend.” In addition, the report found that “horizontal consolidation of commercial insurers is associated with lower prices paid to providers as insurers gain market power in negotiations with providers. However, the lower prices paid to providers do not appear to be passed onto consumers, who face higher premiums following insurer consolidation.”
ASPE notes that the data necessary to evaluate the impact of the NSA on these health care market factors should become available in 2023 and will be used for the next report due January 2024.
