title: The out-of-network benefit: problems and policy solutions.
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.
authors.affiliation: Department of Population Health, NYU School of Medicine, 550 First Ave., VZ30 6th floor, 646, New York, NY 10016, USA. kyanko.kelly@gmail.com
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Kyanko
authors.forename: Susan H
authors.initials: SH
authors.lastname: Busch
mesh_terms: D004632:Emergency Medical Services / Q000191:economics; D006801:Humans; D007348:Insurance, Health / Q000191:economics / Q000458:organization & administration*; D008329:Managed Care Programs / Q000191:economics / Q000458:organization & administration*; D058991:Patient Protection and Affordable Care Act; D057766:Policy; D014481:United States