Independent EM groups are losing in NSA arbitration. PE is winning. Why?
Can folks with EM billing & coding expertise please explain why private equity-owned emergency medicine employers did so much better than non-PE-owned groups in No Surprises Act arbitration in 2023?:
"We found that providers won the vast majority of cases, with decisions averaging 2.65 times the relevant QPA. This finding appears driven by private equity (PE)-backed physician staffing companies winning 90% of their disputes vs just 39% for other emergency physician groups, generating an average IDR payment 63% higher relative to the QPA than non-PE groups."
Source article: Duffy EL, Garmon C, Adler L, Biener A, Trish E. No Surprises Act independent dispute resolution outcomes for emergency services. Health Aff Sch. 2024 Oct 17;2(11):qxae132.
Article pdf link: https://drive.google.com/file/d/1KqvRLNa3iHW8T4tFDHfzbSfnCMY8bNcO/view?usp=sharing
Obvi, if PE-owned EM groups get paid 63% more than independent groups for delivering the same service, they have a massive advantage when competing for ED contracts.
