Association between “Balance Billing” Legislation and Anesthesia Payments in California: A Retrospective Analysis
Authors' conclusion
California's balance billing law was associated with significant declines in out-of-network anesthesia payments in the first 3 yr after implementation. There were mixed statistical and policy significant results for in-network payments and the proportion of out-of-network claims.
Study context
- Population
- Commercially insured patients, California counties, 2013 to 2020from 4,599,936 claims
- Participants
- 43,728 participants
- Exposure
- Anesthesia care payments after vs before California's 2017 balance billing ban, vs office visit payments (comparison)
- Outcome
- Change in out-of-network and in-network anesthesia payment amounts and portion of claims out-of-network after the law's implementation
Methodological detailscounty-level quarterly data, prespecified policy-significance threshold (≥10%)
- County-level quarterly data
- Prespecified policy-significance threshold (≥10%)
Main finding
As reported in the abstract
Anesthesia payments after balance billing law (difference-in-differences vs office visit payments)
Anesthesia care vs Office visitsIncrease in payments for in-network anesthesia care, % (95% CI)P value
Average $87 increase (95% CI, $64 to $110); did not meet the study threshold for policy significance
3.0(0.9–5.1%)
P = 0.007- Average $108 decrease across all procedures (95% CI, -$149 to -$64)
- decline in payments for out-of-network anesthesia care 13.6 % (95% CI −16.5 to −10.6%); P < 0.001
- Nonstatistically significant increase in portion of claims occurring out-of-network
- 10.0% (95% CI, −4.1 to 24.2%; P = 0.155)
Observational data: associations, not effects.
Original publication
Association between “Balance Billing” Legislation and Anesthesia Payments in California: A Retrospective Analysis. Anesthesiology. Published 5 July 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →