The US healthcare system is struggling with spiraling costs and often patients bear the burden. The No Surprises Act legislation was enacted to help protect patients from balance billing. In Claritev’s latest report healthcare payors and providers respond to the new No Surprises Act regulations. Payors and providers are aligned that the No Surprise Act is a positive step toward helping patients from experiencing unexpected costs and could improve perceptions of the healthcare industry as well.
This infographic draws from a recent survey taken by healthcare leaders within provider and payor organizations.
Claritev’s survey results show many healthcare payors and providers respond to the impact of the No Surprises Act with an optimistic outlook, including its potential to drive positive change for patients. Despite differences leading up to the implementation of the No Surprises Act, payors and providers agree it will deliver greater transparency for patients.
However, though leaders see NSA as a positive driver, payors and providers know it is one of many steps needed to address the ails of the US healthcare system. In addition, both face challenges with implementation of the No Surprises Act and will require major process changes. 60% of leaders anticipate difficulty with meeting the tight timelines of the open negotiation and IDR process, with 62% reporting the NSA creates an undue administrative burden for their organization.
As a catalyst for innovation and collaboration, healthcare leaders believe NSA will ultimately help spur digital solutions, with a strong reliance on data, with 50% agreeing NSA will drive innovation and 48% reporting the No Surprises Act is likely to foster more cooperation on pricing issues between parties.
While there is no doubt the No Surprises Act adds a new level of complexity to paying healthcare claims, it isn’t new to Claritev. Well before the NSA became law, Claritev supported clients with similar services for years, such as negotiation to avoid arbitration, building complementary networks, and determining appropriate payment amounts that are fair for all parties. Claritev is now leveraging its expertise to offer organizations end-to-end Surprise Billing Services and customizable solutions for every step of the process to help its healthcare industry partners quickly achieve and stay in compliance.
The data reported is based on the findings from survey which polled healthcare payor and provider executives at the Director level and above, who had strong familiarity with the NSA. The survey was conducted by Questex in December 2021 on behalf of Claritev.
