{"id":3649,"date":"2024-04-07T07:02:05","date_gmt":"2024-04-07T07:02:05","guid":{"rendered":"https:\/\/medexperts.pro\/?p=3649"},"modified":"2024-04-07T07:28:32","modified_gmt":"2024-04-07T07:28:32","slug":"health-insurers-lucrative-alliance-that-drives-up-patient-bills-5-takeaways","status":"publish","type":"post","link":"https:\/\/medexperts.pro\/?p=3649","title":{"rendered":"Health Insurers\u2019 Lucrative Alliance That Drives Up Patient Bills: 5 Takeaways"},"content":{"rendered":"<div><\/div>\n<p id=\"article-summary\" class=\"css-1n0orw4 e1wiw3jv0\">A private-equity-backed firm has helped drive down payments to medical providers, drive up patients\u2019 bills and earn billions for insurers.<\/p>\n<section class=\"meteredContent css-1r7ky0e\">\n<div class=\"css-s99gbd StoryBodyCompanionColumn\">\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">Large health insurers are working with a little-known data company to boost their profits, often at the expense of patients and doctors, <a class=\"css-yywogo\" href=\"https:\/\/www.nytimes.com\/2024\/04\/07\/us\/health-insurance-medical-bills.html\" title>a New York Times investigation<\/a> found. A private-equity-backed firm called MultiPlan has helped drive down payments to medical providers and drive up patients\u2019 bills, while earning billions of dollars in fees for itself and insurers.<\/p>\n<\/div>\n<\/div>\n<div>\n<div data-testid=\"lazy-loader\"><\/div>\n<\/div>\n<div class=\"css-s99gbd StoryBodyCompanionColumn\">\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">To investigate this largely hidden facet of the health care industry, The Times interviewed more than 100 patients, doctors, billing specialists, health plan advisers and former MultiPlan employees, and reviewed more than 50,000 pages of documents, including confidential records made public by two federal judges after petitions from The Times.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Here are five takeaways.<\/p>\n<h2 class=\"css-9ycfei eoo0vm40\" id=\"link-2463a383\">The smaller the payout to doctors, the bigger the fees for insurers and MultiPlan<\/h2>\n<p class=\"css-at9mc1 evys1bk0\">When patients see medical providers outside their plans\u2019 networks, UnitedHealthcare, Cigna, Aetna and other insurers often send the bills to MultiPlan to recommend a payment amount.<\/p>\n<\/div>\n<\/div>\n<div><\/div>\n<div class=\"css-s99gbd StoryBodyCompanionColumn\">\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">MultiPlan and the insurers have a powerful incentive to keep the payments low because their fees get bigger as the payments get smaller.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Here\u2019s how it works.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">The most common way Americans get health coverage is through an employer that pays for workers\u2019 medical care itself and uses an insurance company to administer the plan. Providers in the plan\u2019s network have agreed-upon rates, but out-of-network providers often must negotiate payments.<\/p>\n<div class=\"css-1336jj\">\n<div class=\"css-121kum4\">\n<div class=\"css-171d1bw\"><\/div>\n<div class=\"css-asuuk5\">\n<div class=\"css-7axq9l\" data-testid=\"optimistic-truncator-noscript\">\n<div data-testid=\"optimistic-truncator-noscript-message\" class=\"css-6yo1no\">\n<p class=\"css-3kpklk\">We are having trouble retrieving the article content.<\/p>\n<p class=\"css-3kpklk\">Please enable JavaScript in your browser settings.<\/p>\n<\/div>\n<\/div>\n<div class=\"css-1dv1kvn\" id=\"optimistic-truncator-a11y\">\n<hr \/>\n<p>Thank you for your patience while we verify access. If you are in Reader mode please exit and\u00a0<a href=\"https:\/\/myaccount.nytimes.com\/auth\/login?response_type=cookie&amp;client_id=vi&amp;redirect_uri=https%3A%2F%2Fwww.nytimes.com%2F2024%2F04%2F07%2Fus%2Fhealth-insurance-medical-bills-takeaways.html&amp;asset=opttrunc\">log into<\/a>\u00a0your Times account, or\u00a0<a href=\"https:\/\/www.nytimes.com\/subscription?campaignId=89WYR&amp;redirect_uri=https%3A%2F%2Fwww.nytimes.com%2F2024%2F04%2F07%2Fus%2Fhealth-insurance-medical-bills-takeaways.html\">subscribe<\/a>\u00a0for all of The Times.<\/p>\n<hr \/>\n<\/div>\n<div class=\"css-1g71tqy\">\n<div data-testid=\"optimistic-truncator-message\" class=\"css-6yo1no\">\n<p class=\"css-3kpklk\">Thank you for your patience while we verify access.<\/p>\n<p class=\"css-3kpklk\">Already a subscriber?\u00a0<a data-testid=\"log-in-link\" class=\"css-z5ryv4\" href=\"https:\/\/myaccount.nytimes.com\/auth\/login?response_type=cookie&amp;client_id=vi&amp;redirect_uri=https%3A%2F%2Fwww.nytimes.com%2F2024%2F04%2F07%2Fus%2Fhealth-insurance-medical-bills-takeaways.html&amp;asset=opttrunc\">Log in<\/a>.<\/p>\n<p class=\"css-3kpklk\">Want all of The Times?\u00a0<a data-testid=\"subscribe-link\" class=\"css-z5ryv4\" href=\"https:\/\/www.nytimes.com\/subscription?campaignId=89WYR&amp;redirect_uri=https%3A%2F%2Fwww.nytimes.com%2F2024%2F04%2F07%2Fus%2Fhealth-insurance-medical-bills-takeaways.html\">Subscribe<\/a>.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/section>\n","protected":false},"excerpt":{"rendered":"<p>A private-equity-backed firm has helped drive down payments to medical providers, drive up patients\u2019 bills and earn billions for insurers.Large health insurers are working with a little-known data company to boost their profits, often at the expense of patients and doctors, a New York Times investigation found. A private-equity-backed firm called MultiPlan has helped drive down payments to medical providers and drive up patients\u2019 bills, while earning billions of dollars in fees for itself and insurers.To investigate this largely hidden facet of the health care industry, The Times interviewed more than 100 patients, doctors, billing specialists, health plan advisers and former MultiPlan employees, and reviewed more than 50,000 pages of documents, including confidential records made public by two federal judges after petitions from The Times.Here are five takeaways.The smaller the payout to doctors, the bigger the fees for insurers and MultiPlanWhen patients see medical providers outside their plans\u2019 networks, UnitedHealthcare, Cigna, Aetna and other insurers often send the bills to MultiPlan to recommend a payment amount.MultiPlan and the insurers have a powerful incentive to keep the payments low because their fees get bigger as the payments get smaller.Here\u2019s how it works.The most common way Americans get health coverage is through an employer that pays for workers\u2019 medical care itself and uses an insurance company to administer the plan. Providers in the plan\u2019s network have agreed-upon rates, but out-of-network providers often must negotiate payments.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and\u00a0log into\u00a0your Times account, or\u00a0subscribe\u00a0for all of The Times.Thank you for your patience while we verify access.Already a subscriber?\u00a0Log in.Want all of The Times?\u00a0Subscribe.<\/p>\n","protected":false},"author":1,"featured_media":3651,"comment_status":"close","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[33],"tags":[],"class_list":["post-3649","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health"],"_links":{"self":[{"href":"https:\/\/medexperts.pro\/index.php?rest_route=\/wp\/v2\/posts\/3649","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medexperts.pro\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medexperts.pro\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medexperts.pro\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/medexperts.pro\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=3649"}],"version-history":[{"count":2,"href":"https:\/\/medexperts.pro\/index.php?rest_route=\/wp\/v2\/posts\/3649\/revisions"}],"predecessor-version":[{"id":3652,"href":"https:\/\/medexperts.pro\/index.php?rest_route=\/wp\/v2\/posts\/3649\/revisions\/3652"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medexperts.pro\/index.php?rest_route=\/wp\/v2\/media\/3651"}],"wp:attachment":[{"href":"https:\/\/medexperts.pro\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=3649"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medexperts.pro\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=3649"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medexperts.pro\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=3649"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}