Lancaster Physician Spring 2021 - 24

L A N C A S T E R M E D I C A L S O C I E T Y.O R G

Patient Advocacy

out of another state? The insurer will have
to cover them and offer the in-network rate.
For Physicians: Health plans will be
required to pay within 30 days. If you don't
agree with the in-network rate of usual and
customary charges, disputes go to an arbitrator who will agree with whichever side is
closer to the median in-network rate in the
region as of 2019 inflation adjusted against
the CPI-U inflation index.
American Rescue Plan Act
(March 11th, 2021)
This piece of legislation is still hot off the
press, but with the depth of details surrounding it, we are aware there are changes on the
horizon to CHIP, Medicaid, and individual
health programs across the United States.
THE FUTURE OF PRICE TRANSPARENCY?
Transparency will provide two different
forces in health care. Obviously, having

access to expenses makes for a more educated
consumer when it comes to costs. With that
said, a less obvious impact is if pricing is
available to the public, different negotiated
physician costs will level out. Before, a hospital, vendor, insurer, or physician may have
negotiated the best deal. Now, those same
partners will be able to see whether or not
they actually have paid or been paid fairly
and request the median price.

industry isn't going anywhere. People will
always need access to quality health care.
1. KFF's Estimated Total Premium Tax Credits
Received by Marketplace Enrollees. Data Source: Early
2020 Effectuated Enrollment Snapshot, Centers for
Medicaid and Medicare Services (CMS), July 23,
2020.
2. " CMS Financial Report 2019, " Pg 27. Centers for
Medicaid and Medicare Services (CMS), March 11th,
2021, https://www.cms.gov/files/document/cms-financial-report-fiscal-year-2019.pdf.

In the finance industry, fee transparency on
investment accounts created a bottom of the
barrel-like outcome where many brokerage
accounts now have zero or nearly zero trading
costs. This has not put investment advisors
out of business, rather their underlying value
has been more pronounced to individuals
looking to offload responsibility. We don't see
a race to the bottom, we see an opportunity
to educate consumers on actual costs of care
and level out price differences from one
plan to the next. Regardless, the health care

Assurance in the
Face of Change.
Find it with a
Domani Wealth Advisor.

Angie Stephenson, CFP®, CPA/PFS
angie.stephenson@domaniwealth.com

Ken Eshleman, CFP®
ken.eshleman@domaniwealth.com

Lancaster Office | 717.393.9721
domaniwealth.com

Domani Wealth, LLC ( " Domani " ) is an SEC registered investment adviser with its principal place of business in Lancaster, Pennsylvania. Domani and its representatives may only transact
business in states where they are appropriately notice-filed and registered, respectively, or exempt from such requirements. For information pertaining to the registration status of Domani,
please contact the SEC or the state securities regulators for those states in which Domani maintains a notice-filing.

LANCASTER

24

PHYSICIAN


https://www.cms.gov/files/document/cms-financial-report-fiscal-year-2019.pdf https://www.cms.gov/files/document/cms-financial-report-fiscal-year-2019.pdf http://www.domaniwealth.com

Lancaster Physician Spring 2021

Table of Contents for the Digital Edition of Lancaster Physician Spring 2021

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https://www.nxtbook.com/hoffmann/Lancaster_Physician/Fall2017
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