The Out-of-Network Benefit: Problems and Policy Solutions

Source: Kelly A. Kyanko and Susan H. Busch, Inquiry, Vol. 49 No. 4, Winter 2012/2013
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From the abstract:
Health insurance plans that include coverage for out-of-network providers are common and have the potential to reduce health care costs and even improve quality. Yet, consumers may be exposed to significant unexpected and unreasonable out-of-pocket costs due to lack of accurate information on network participation, nontransparent out-of-pocket costs, inadequate provider networks, involuntary use of out-of-network emergency care, and use of out-of-network providers at in-network hospitals. Although the Affordable Care Act and some states provide some consumer protections, these may not be adequate.