Out-of-network hospital payment caps could save $124B a year, RAND finds

Becker's Healthcare March 11, 2020
Morgan Haefner

If out-of-network hospital payments were capped, up to $124 billion could be saved annually, according to new findings published by RAND Corp.

To come to this conclusion, RAND researchers studied four proposals that cap out-of-network hospital billing to:

• 125 percent of Medicare payment rates
• 200 percent of Medicare payment rates
• the average of payments made by private health plans in a state, and
• 80 percent of average billed charges in a state

Under a strict proposal like limiting out-of-network payments to 125 percent of Medicare rates, the...

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