Capping Out-of-Network Payments Could Save as Much as Medicare-for-All

HealthLeaders Media March 12, 2020
Jack O'Brien

Under the strictest cap on out-of-network charges, in-network negotiated hospital prices could fall by $124 billion per year.

Policy proposals that limit out-of-network payments to hospitals could deliver cost savings comparable to those produced under a ‘Medicare-for-All’ style system, according to a RAND Corporation study released Thursday morning.

RAND examined four different proposals to address surprise medical bills, ranging from out-of-network payment limits at 125% of Medicare rates to 80% of average billed charges in a state.

Under the strictest cap on out-of-network charges, in-network negotiated hospital prices could fall between 31% to 40% per year, or $108 billion to $124 billion.

One proposal which would set a limit at 200% of Medicare rates, could lead to reduced hospital prices...

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