Congress has been abuzz with proposals set out to slash surprise billing, and if legislation gets off the ground, providers that treat a higher volume of out-of-network patients will take the biggest hit, according to a Moody's analysis cited in Fierce Healthcare.
While exact details of the forthcoming law are still being ironed out, surprise billing legislation will likely pass in the next 12 months despite hospitals' aggressive lobbying efforts.
Hospital groups like the American Hospital Association have been putting up a fight against the proposals, as any form of legislation would likely mean skimpier payments for providers. But hospitals' protests are likely to be in vain — support for surprise billing from Democrats and Republicans alike means legislation is likely to pass.
But not all provider organizations will be affected proportionately.
We think surprise billing legislation will trigger accelerated hospital consolidation as smaller providers turn to mergers or seek refuge in larger organizations. The law will likely make it financially infeasible for smaller providers to treat a large volume of out-of-network patients, leading to buyouts from larger firms looking to expand their footprint.
Merger and acquisition (M&A) activity among hospitals sunk to a 10-year low in Q1 2019, totaling just 14, down from 40 year-over-year in 2018, per a Ponder & Co. report. But it's generally trending upward, and I (Zoë) predict that, with surprise billing legislation on the horizon, we'll see this activity tick up to even greater heights over the next five years.
Interested in getting the full story? Here are two ways to get access:
1. Sign up for Digital Health Pro, Business Insider Intelligence's expert product suite keeping you up-to-date on the people, technologies, trends, and companies shaping the future of healthcare, delivered to your inbox 6x a week. >> Get Started
2. Subscribe to a Premium pass to Business Insider Intelligence and gain immediate access to Digital Health Pro, plus more than 250 other expertly researched reports. As an added bonus, you'll also gain access to all future reports and daily newsletters to ensure you stay ahead of the curve and benefit personally and professionally. >> Learn More Now