In this webinar, legal and health economics experts will provide background on NAHSP’s newest model legislation, An Act to Limit Out-of-Network Provider Rates, which will be released in mid-November. This new model aims to address high and rising prices that increasingly result in unaffordable health care for purchasers, including consumers. Essentially, the policy aims to decrease the financial incentive for providers to abandon negotiations with health plans and go out-of-network. It is anticipated that providers will be more likely to remain in-network and that health plans can negotiate lower in-network payment rates, thus reducing overall spending. Speakers will share how out-of-network payment limits may level the bargaining dynamic between carriers and powerful providers, which could result in lower costs and increased access for patients. Additionally, an official from Oregon’s state employee health plan will react to the new model and share insights on how the state implemented a similar out-of-network rate limit for Oregon state employees.

Moderator: Maureen Hensley-Quinn, Senior Program Director, Coverage, Cost & Value, NASHP

• Erin Fuse Brown, Catherine C. Henson Professor of Law and Director, Center for Law, Health & Society, Georgia State University
• Michael Chernew, Leonard D. Schaeffer Professor of Health Care Policy and Director, Healthcare Markets and Regulation Lab, Department of Health Care Policy, Harvard Medical School
• Bob Murray, President, Global Health Payment LLC
• Margaret Smith-Isa, Program Development Specialist, Oregon Public Employees’ Benefit Board & Oregon Educators’ Benefit Board, Oregon Health Authority