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Out-of-Network Air Ambulance Bills: Prevalence, Magnitude, and Policy Solutions

"[The authors] found that less than one-quarter of air ambulance transports of commercially insured patients were in-network. Two-in-five transports resulted in a potential balance bill, averaging $19,851.... [I]n-network rates for transports by independent (non-hospital-based) carriers averaged $20,822, or 369% of the Medicare rate for the same service."

Telehealth Private Payer Laws: Impact and Issues (PDF)

"[T]his study seeks to achieve a better understanding of the following policy factors that greatly affect the effectiveness of private payer laws: ... [1] Is the presence or lack of certain language or phrases a help or hindrance to the utilization of telehealth? ... [2] Does the law require a payment amount for telehealth-delivered services to be equal to what is given for in-person services? ... [3] Are there any limitations on what type of telehealth modality can be used? ... [4] Are there any limitations on where a telehealth service can take place? ... [5] Are there any limitations on the types of providers who may provide services via telehealth and/or the types of specialty it can be used for?"

Markets and Medical Care: The United States, 1993–2005

Excerpt: This article looks at the experience in the American medical marketplace over more than a decade, showing how markets function as institutions in which participants who are self-seeking, but not perfectly rational, exercise power over other participants in the market. Cost experience here was driven more by market power over prices than by management of utilization. Instead of following any logic of efficiency or equity, system transformations were driven by beliefs about investment strategies.

Mental Health Parity: What Can It Accomplish in a Market Dominated by Managed Care?

Originally published June, 1998. Excerpt: Managed care's ability to hold down health costs has made parity somewhat more acceptable to many employers and legislators, and parity proponents are happy to take advantage of this fact. Yet parity proponents are often far from happy about the way managed care actually works in many mental health areas. The following discussion does not argue for or against parity, but simply attempts a balanced look at the subject.