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A couple of articles about balance billing came out last week, including this one published on Slate. The practice refers to how out-of-network physicians are generally entitled to bill patients when their insurance plan does not cover the full amount owed. Years ago, the general sentiment would have been that patients should have been more careful to stay within their plans' network. Over the last few years, however, a number of articles have come out detailing how patients have indeed been checking that their providers are in-network, but being surprised by balance billing when out-of-network providers get involved. For example, if a surgeon encounters a complication and would like to get a consultation or some assistance from an out-of-network provider, who should pay?

A couple of articles about balance billing came out last week, including this one published on Slate. The practice refers to how out-of-network physicians are generally entitled to bill patients when their insurance plan does not cover the full amount owed. Years ago, the general sentiment would have been that patients should have been more careful to stay within their plans' network. Over the last few years, however, a number of articles have come out detailing how patients have indeed been checking that their providers are in-network, but being surprised by balance billing when out-of-network providers get involved. For example, if a surgeon encounters a complication and would like to get a consultation or some assistance from an out-of-network provider, who should pay?

When patients check ahead of time that both the facilities that they are visiting and their providers are both in-network, balance billing is a symptom of a much bigger debate between payers and providers where patients tend to be collateral damage. Payers feel that providers are asking for too much and might not sign on some providers, and providers feel that payers pay too little and don't accept certain plans. Instead of an upfront resolution, the patient is caught in the crossfire. From the patient perspective, the key question seems to revolve around whether a facility should be able to call itself in-network if patients being treated there might be exposed to out-of-network charges. When patients have done the due diligence of figuring out whether both the facility and the provider are in-network, what more can be reasonably expected of them?

We've revamped the process for people to leave reviews on our site. Users no longer need to create an account before they leave a review. Instead, users can simply fill out a form, including leaving an e-mail address. The e-mail address is not published, but is used to confirm that the address is indeed active. Upon receiving the confirmation e-mail, users can publish the review they submitted.

We've revamped the process for people to leave reviews on our site. Users no longer need to create an account before they leave a review. Instead, users can simply fill out a form, including leaving an e-mail address. The e-mail address is not published, but is used to confirm that the address is indeed active. Upon receiving the confirmation e-mail, users can publish the review they submitted.

We hope this simplifies the review process, and we also hope that you'll take some time to let others know how you felt about medical providers that you have recently visited for treatment.

The Health Care Incentives Improvement Institute (HCI3) released their annual report card on State Price Transparency Laws. While the overwhelming majority of states (43) received the lowest possible grade (F), a couple of states made progress since last year's report card. Only three states -- Colorado, Main, and New Hampshire -- received the highest grade possible, but two of them received a lower grade last year. Progress for health care transparency moves forward slowly, but it does seem to be moving forward. It will be interesting to see whether there will at some point be an inflection point where the rate will accelerate.

The Health Care Incentives Improvement Institute (HCI3) released their annual report card on State Price Transparency Laws. While the overwhelming majority of states (43) received the lowest possible grade (F), a couple of states made progress since last year's report card. Only three states -- Colorado, Main, and New Hampshire -- received the highest grade possible, but two of them received a lower grade last year. Progress for health care transparency moves forward slowly, but it does seem to be moving forward. It will be interesting to see whether there will at some point be an inflection point where the rate will accelerate.

HCI3 grades states on whether they collect and publish payment data for medical services, including on whether or not the website is user-friendly. We agree that those attributes are positive, and hope that states will also consider releasing this data in machine-readable form so that other websites can innovate further.

Earlier this year, the Centers for Medicare & Medicaid Services (CMS) encountered some criticism when they prepared to release their overall hospital ratings, with even senators chiming in. CMS has already released ratings information on specific criteria, but those are often too granular for the average consumer. These overall hospital ratings are meant to simplify the consumer experience. After a few months of deliberation, CMS recently announced that they plan on going ahead with their release of overall hospital ratings.

Earlier this year, the Centers for Medicare & Medicaid Services (CMS) encountered some criticism when they prepared to release their overall hospital ratings, with even senators chiming in. CMS has already released ratings information on specific criteria, but those are often too granular for the average consumer. These overall hospital ratings are meant to simplify the consumer experience. After a few months of deliberation, CMS recently announced that they plan on going ahead with their release of overall hospital ratings.

As expected, some from the medical community continue to object. Kaiser Health News reported that an executive at the Association of American Medical Colleges protested that the ratings must be flawed given that many prestigious have low ratings. Reputations are certainly a reasonable sanity check to think about, but given how subjective they are, it's unclear whether the differences clearly point to a problem with the rating system or whether some reputations have so far been unwarranted. A more constructive approach would be for the medical community to criticize specific metrics or specific weightings -- doing so, however, would almost force them to suggest alternatives, which they seem reluctant to do. To be clear, no one thinks that these ratings are perfect (probably even people at CMS); what's being debated here is whether these ratings are a reasonable next step.

From a consumer perspective, the individual ratings have been criticized before for their lack of variation among different hospitals; that is, the vast majority of hospitals got an average rating, rendering the ratings mostly useless. It appears that only about one half of the hospitals will receive three out of five stars, suggesting that these ratings are likely to be more helpful to consumers.

President Obama published a paper in JAMA, touting how the Affordable Care Act has been successful. The paper also recommended increasing competition, whether that be via a public plan in areas that only have one or two insurers, or whether that be streamlining the process to approve biosimilar drugs. Bloomberg commented on the paper in the context of two proposed major mergers in the health insurance industry.

President Obama published a paper in JAMA, touting how the Affordable Care Act has been successful. The paper also recommended increasing competition, whether that be via a public plan in areas that only have one or two insurers, or whether that be streamlining the process to approve biosimilar drugs. Bloomberg commented on the paper in the context of two proposed major mergers in the health insurance industry.

Competition is certainly important in reducing costs and improving quality across an industry. Ironically, though, a public option might be unfair competition if the government significantly subsidizes it, and might serve to diminish competition if the incumbents believe that they cannot compete. An alternative policy is for the government to offer subsidies (available to either all insurers or all patients) in markets where there are fewer than three insurers.