Are You in Your Patient's Insurance Company's Network?

Legislation is being considered in many states that would prevent balance billing for patients receiving emergency care from out-of-network providers. Investigators sought to determine the proportion of hospital-based physicians in four specialties (emergency medicine, anesthesia, pathology, and radiology) who were “in-network” for randomly selected locally available insurance plans offered through the federal and state marketplace exchanges. They estimated the likelihood that physicians at a given hospital were in-network by searching for the residency program director's name or the practice group's name in the provider directory.

They studied 79 teaching hospitals participating in 144 locally available insurance plan networks in 2015. Rate…