Patient Costs Increase Under Insurance Payment Method

A 2009 health insurance settlement required insurers to underwrite a new database that collects bills from insurers to calculate "usual and customary charges" for procedures in a given region. However, insurers were not required to use the database to calculate payments for out-of-network care and instead have used a calculation method based on Medicare rates that often results in lower provider reimbursements and higher patient costs.

• "Insurers Alter Cost Formula, and Patients Pay More" (Bernstein, New York Times, 4/23).