\n\tDan Weissmann<\/span><\/p>\n

Some people who expected their health insurance to cover some out-of-network care have been getting stuck with enormous bills.<\/p>\n

One Kansas City, Kansas, couple paid thousands of dollars out-of-pocket and up-front for care. They expected to get a partial reimbursement from their insurer. So, they were shocked when instead they got a bill saying they owed even more than what they\u2019d already paid.<\/p>\n

It turns out, a little-known data firm called MultiPlan was working with their insurance company to suggest cuts to their coverage. MulitPlan says it\u2019s helping control ballooning health care costs by keeping hospitals and providers from overbilling. But it\u2019s often patients left paying the difference.In this episode of \u201cAn Arm and a Leg,\u201d host Dan Weissmann breaks down this confusing world of out-of-network care with New York Times reporter Chris Hamby, who recently published an investigation<\/a> into MultiPlan.<\/p>\n

\tDan Weissmann<\/p>\n

\t\t\t
\n\t\t\t\t@danweissmann\t\t\t<\/a><\/p>\n

\t\t\tHost and producer of “An Arm and a Leg.” Previously, Dan was a staff reporter for Marketplace and Chicago’s WBEZ. His work also appears on All Things Considered, Marketplace, the BBC, 99 Percent Invisible, and Reveal, from the Center for Investigative Reporting.\t\t<\/p>\n

\n\t\tCredits\t<\/h3>\n
\tEmily Pisacreta
\n\tProducer<\/p>\n
\tClaire Davenport
\n\tProducer<\/p>\n
\tAdam Raymonda
\n\tAudio wizard<\/p>\n
\tEllen Weiss
\n\tEditor<\/p>\n
\t\t\t\t\tClick to open the Transcript\t\t\t\t<\/p>\n
\t\t\t\t\t\tTranscript<\/strong>: Meet the Middleman\u2019s Middleman<\/strong>\t\t\t\t<\/p>\n
Note: \u201cAn Arm and a Leg\u201d uses speech-recognition software to generate transcripts, which may contain errors. Please use the transcript as a tool but check the corresponding audio before quoting the podcast.<\/em><\/p>\n
Dan: <\/strong>Hey there! Paul and Kristin live in Kansas City with their two kids. Kristin and their daughter, the older kid\u2013 they have some complex medical issues, need to see some specialized folks. And some of those folks don\u2019t take Kristin and Paul\u2019s insurance. They\u2019re \u201cout of network,\u201d so Kristin and Paul pay out of pocket\u2013 a lot. Maybe $20,000 a year. BUT their health insurance plan does reimburse some out-of-network care.\u00a0<\/p>\n
o, in January 2023, Kristin called a help line connected with the insurance plan to find out how that was gonna work.\u00a0<\/p>\n
Kristin H: They basically said, sure, easy peasy, you pay and then you get online and you click this form, you show what you paid, and then we send you a check and reimburse you.\u00a0<\/strong><\/p>\n
Dan: <\/strong>Kristin was on it. She built a whole spreadsheet to track every bill she paid, every reimbursement form she\u2019d submitted. And she waited for the checks. The insurance company gave itself months just to process the claims. And when they finally sent statements, the statements seemed \u2026 weird. They were like:\u00a0<\/p>\n
Kristin H: Here\u2019s what you paid, and here\u2019s your discounts, and here\u2019s what you may owe.\u00a0<\/strong><\/p>\n
Dan:<\/strong> And Kristin was like \u2026 what?\u00a0<\/p>\n
Kristin H: Because I was thinking, well, I don\u2019t owe anything. We paid out of pocket, but then I was thinking, well, this must be the portion that they\u2019re paying us back. But then the math didn\u2019t add up.\u00a0<\/strong><\/p>\n
Dan: <\/strong>Yeah. Not at all. Kristin was expecting to get 50 percent back, like her plan said she would. But this amount wasn\u2019t anything like 50 percent. And what\u2019s this \u201cdiscount\u201d business?\u00a0<\/p>\n
It took months\u2013 and a lot of digging from Paul, and ultimately a talk with a NewYork Times reporter\u2013 before Kristin and Paul understood what was going on, and why it was costing them thousands of dollars.\u00a0<\/p>\n
What they didn\u2019t know until that New York Times story came out was: Someone was making a multi-billion dollar business out of experiences like theirs. As that story made clear, LOTS of people who expected their insurance to cover them for expensive out-of-network care ended up on the hook for a lot more than they\u2019d expected.\u00a0<\/p>\n
That story introduced readers to a character who\u2019s become kind of a TYPE on this show. Not a type of person, but a type of business: A middleman that works behind the scenes with insurance companies. So we\u2019ve seen that dynamic with pharmacy benefit managers\u2013 the folks who decide what drugs you can get and for how much\u2013 and more recently, we looked at a company that uses an algorithm to justify kicking folks out of nursing homes. The middleman in this New York Times story was a company called MultiPlan.\u00a0<\/p>\n
Reporter Chris Hamby found MultiPlan and insurance companies they worked with were leaving patients on the hook for huge amounts that they absolutely had not expected to pay. MultiPlan was also, along with those insurance companies, pocketing big fees. That story got some folks\u2019 attention. A U.S. Senator has called for action from antitrust regulators. Those regulators might get interested. And we may wanna egg them on\u2013 so we\u2019re gonna need to understand the whole scheme. Whothis middleman is\u2013 MultiPlan\u2013 and how they got themselves in the middle of 60 million people\u2019s health insurance, by their own estimate \u2026 and how they make a lot of money.\u00a0<\/p>\n
This is An Arm and a Leg, a show about why health care costs so freaking much, and what we can maybe do about it. I\u2019m Dan Weissmann. I\u2019m a reporter, and I like a challenge. So, our job on this show is to take one of the most enraging, terrifying, depressing parts of American life\u2013 and bring you a show that\u2019s entertaining, empowering, and useful.\u00a0<\/p>\n
And this time, I\u2019ve got help.\u00a0<\/p>\n
Chris Hamby: My name is Chris Hamby. I\u2019m a reporter on the investigations desk at the New York Times.\u00a0<\/strong><\/p>\n
Dan: <\/strong>Yeah, and of course, Chris is the one who spent months figuring out the story of this middleman company, MultiPlan.\u00a0<\/p>\n
Chris Hamby: I was poking around a number of areas related to health insurance, and this name just kept coming up.\u00a0<\/strong><\/p>\n
Dan: <\/strong>Like in lawsuits.\u00a0<\/p>\n
Chris Hamby: And it wasn\u2019t always terribly clear what they did exactly or how they were compensated.\u00a0<\/strong><\/p>\n
Dan: <\/strong>Or how doctors and patients\u2013 regular people\u2013 were affected.\u00a0<\/p>\n
Chris Hamby: So that\u2019s why I decided to try and figure this out, and it\u2019s sort of an opaque space as so many areas of health care are these days.\u00a0<\/strong><\/p>\n
Dan: <\/strong>Yeah. In fact, in order to understand this story at all\u2013 to understand who\u2019s doing WELL in this scenario\u2013 we\u2019ve gotta peel back a layer. It\u2019s something we\u2019ve talked about here before, but not for a while, and you know, not even my mom remembers everything I\u2019ve ever said here.\u00a0<\/p>\n
This is about the mechanics of how most health insurance people get from their job actually works: about who actually pays medical bills when your insurance settles a claim. It\u2019s not the insurance company. It\u2019s actually the employer paying those bills.\u00a0<\/p>\n
Of course, employers don\u2019t know how to actually RUN an insurance plan. [Unless the employer is Aetna, I guess]. So they hire insurance companies to administer them. You get a card that says Cigna or Blue Cross, but your employer\u2019s funds actually pay the medical bills, so these are called \u201cself-funded\u201d plans. But this is all stuff most of us are just not aware of.\u00a0<\/p>\n
Here\u2019s Chris Hamby:\u00a0<\/p>\n
Chris Hamby: I hadn\u2019t, until about a year ago, even heard of a self-funded plan. And I like to think that I\u2019m reasonably well informed on this stuff.\u00a0<\/strong><\/p>\n
Dan: <\/strong>Yeah, that is putting it mildly. Chris made his name and won a Pulitzer Prize covering workplace health issues. So, just park that for a minute: self-funded plan, where the employer is the \u201cself,\u201d actually paying the bills, and paying the insurance company a fee. The insurance company is a middleman.\u00a0<\/p>\n
OK, now, next layer: The middleman\u2019s middleman. In this case, the company MultiPlan that Chris wrote about. What\u2019s their job? So in this story, the job they\u2019re doing\u2013 their middleman job\u2013 is to address what is admittedly kind of a tough question: If you go see somebody\u2013 a doctor, a therapist\u2013 who doesn\u2019t take your insurance, what happens?\u00a0<\/p>\n
Chris Hamby: How do you determine what a fair amount to pay the provider is? And by extension, how much is the patient potentially on the hook for the unpaid balance? And that has long been a contentious issue.\u00a0<\/strong><\/p>\n
Dan: <\/strong>Because, if they don\u2019t take your insurance, a provider could charge \u2026 absolutely anything. So is your insurer\u2013 and again, that\u2019s often actually your employer\u2013 supposed to pay absolutely anything? How much are they supposed to pay? Figuring that out, it\u2019s a job.\u00a0<\/p>\n
About 15 years ago, another middleman company doing that job got sued by the NewYork state attorney general. The state said this earlier middleman\u2019s way of figuring out what to pay was screwing over both providers and patients. And the state\u2019s lawsuit produced a solution.\u00a0<\/p>\n
Chris Hamby: The insurance companies agreed to fund the creation of a nonprofit entity that was going be sort of an independent, neutral arbiter of fair prices. It was going to collect data from all the insurers and just make it publicly available. Make sure it was transparent to everyone.\u00a0<\/strong><\/p>\n
Dan: <\/strong>This nonprofit is called FAIR Health, and its data is actually public. It still exists. Like, you can use it yourself \u2014 you can look up the going rate for a knee replacement, a blood test, whatever.\u00a0<\/p>\n
Chris Hamby:<\/strong> You can plug in your zip code, plug in your medical procedure and see an estimate of what, you know, typical out-of-network charges and in-network charges would be for these.\u00a0<\/strong><\/p>\n
Dan: <\/strong>It\u2019s cool! Check it out yourself; it\u2019s useful. And all the major insurance companies agreed to use it\u2013 to use FAIR Health\u2019s benchmarks\u2013 to decide what to pay for out-of-network stuff. But, those agreements only committed insurance companies to using FAIR Health for \u2026 five years. They expired in 2014.\u00a0<\/p>\n
Enter middleman companies like MultiPlan, saying to insurance companies: Hey, you COULD use FAIR Health\u2013 or you could route out-of-network bills to us: Hire us to get you an even better deal\u2013 better prices.\u00a0<\/p>\n
Chris Hamby: And it\u2019s important to note also that this is a time when private equity is investing in healthcare, and there are some legitimate concerns about driving up those list prices to ridiculously high levels in a lot of cases. So, there were real issues that insurers were saying that they were responding to at the time.<\/strong><\/p>\n
Dan:<\/strong> OK, so that\u2019s the pitch. MultiPlan is saying to insurance companies: We\u2019ll help you hold the line. We can save you more money than if you used FAIR Health. Well, kind of. Because here\u2019s where we come back to the whole thing about self-funded insurance. MultiPlan isn\u2019t saying, \u201cWe can save YOU, insurance company, more money than if you used FAIR Health.\u201d They\u2019re saying, \u201cWe can help you save your CLIENTS\u2013 employers who do self-funded health insurance\u2013 more money. And when you save them money, you\u2019re gonna make money. Because you can charge them a percentage of what you\u2019re saving them. And we\u2019ll get a percentage too.\u201d A percentage of the savings. On every single bill. That\u2019s a very different deal than just using FAIR Health\u2019s data.\u00a0<\/p>\n
Chris Hamby: FAIR Health is not taking a percentage of the savings that they obtain. They\u2019re just selling you their data. And the insurers typically are not charging employers a fee for using FAIR Health\u2019s data. But if they use MultiPlan\u2019s data, both MultiPlan and the insurer typically charge a fee.\u00a0<\/strong><\/p>\n
Dan: <\/strong>A percentage. In examples from Chris\u2019s story, the insurance company gets 35 percent of those savings.\u00a0<\/p>\n
Chris Hamby: And this has become a significant amount of money for a lot of insurance companies. Overall, UnitedHealthcare, is up to, you know, around a billion dollars per year in recent years.\u00a0<\/strong><\/p>\n
Dan: UnitedHealthcare collects like a billion dollars in fees for these services, basically, for using MultiPlan specifically?\u00a0<\/strong><\/p>\n
Chris Hamby: And they couch that by saying some other out-of-network savings programs, but yes.\u00a0<\/strong><\/p>\n
Dan: Whooh!\u00a0<\/strong><\/p>\n
Chris Hamby: One thing that the insurers say is that the employers are aware of this; they\u2019ve signed up for it.\u00a0<\/strong><\/p>\n
Dan:<\/strong> That employers are hiring, say, Cigna, with MultiPlan to find savings. And employers are agreeing to the fees.\u00a0<\/p>\n
Chris Hamby: Where it gets a little bit dicier from the employer\u2019s perspective is when you see claims where, for instance, you end up paying the insurance company more in fees than you paid the doctor for treating your employee.\u00a0<\/strong><\/p>\n
Dan:<\/strong> yeah, one example from Chris\u2019s story: An out-of-network provider wanted more than $150,000 on one bill. And after the insurance company and MultiPlan did their bit, the employer, a trucking company, ended up paying $58,000. Eight thousand for the provider, and $50,000 to the insurance company and MultiPlan. So, on the one hand, the employer maybe saved $90,000. But paying $50,000 for \u201ccost containment?\u201d Maybe doesn\u2019t sound like such a bargain.\u00a0<\/p>\n
Some employers and a union that runs a health plan have filed lawsuits looking for some of that money back. And there\u2019s also a big irony here because MultiPlan\u2019s pitch is, you need us because sticker prices are super-wildly high. But MultiPlan isn\u2019t doing anything to contain the sticker prices as a systemic problem. In fact, the higher providers crank up their sticker prices, the more money MultiPlan and the insurance companies they work with can make. But then there\u2019s a big question too, which is, what happens to the rest of that bill for the sticker price? Who pays that? That\u2019s next \u2026\u00a0<\/p>\n
This episode of An Arm and a Leg is a co-production of Public Road Productions and KFF Health News. The folks at KFF Health News are amazing journalists. Their work wins all kinds of awards, every year. We\u2019re honored to work with them.\u00a0<\/p>\n
So, a provider sends a bill. MultiPlan and the insurance company say, \u201cWoah, way too much.\u201d And then what happens? Well, it depends. Sometimes, MultiPlan negotiates with the provider. They\u2019ve got people who do this. And those negotiators drive hard bargains. According to Chris\u2019s story, negotiators sometimes tell providers: Here\u2019s my offer, you\u2019ve got a few hours to take it or leave it, and my next offer might be lower.\u00a0<\/p>\n
Chris talked with a pediatric therapist who said an offer based on MultiPlan\u2019s calculation was less than half of what Medicaid pays. Less than half. And Medicaid rates\u2013 they\u2019re notoriously pretty low. Chris talked with some of MultiPlan\u2019s negotiators too.\u00a0<\/p>\n
Chris Hamby: It was interesting because some of the negotiators felt that they were doing their part to hold down costs and really sort of stick it to providers and hospitals that were price gouging.\u00a0<\/strong><\/p>\n
Dan: <\/strong>But \u2026one told Chris she knew the offers she made\u2013 they weren\u2019t fair. \u201cIt\u2019s just a game,\u201d another one said. \u201cIt\u2019s sad.\u201d And maybe the difference is that some of these negotiators were thinking of a big hospital charging $150,000\u00a0 for something. And maybe some of them were thinking of someone like that therapist\u2013 the one who got offered less than half of Medicaid\u2019s rate.\u00a0<\/p>\n
And I\u2019m not gonna get into the question of who should be doing this kind of negotiating, or what\u2019s fair. I mean, not today, anyway. Because: in a lot of cases with MultiPlan, there\u2019s no negotiation at all. Negotiation only happens when the employer has told the insurance company, look, protect my people. Figure out SOMETHING with the provider so they don\u2019t go after my workers for the rest.\u00a0<\/p>\n
But that doesn\u2019t always happen. A lot of the time, what happens is: The provider sends a bill. The insurance company kicks in whatever it decides to \u2026 and that\u2019s it.\u00a0<\/p>\n
So Chris\u2019s story opens with a woman who had surgery. With MultiPlan\u2019s help, her insurance company decided to pay about $5,400. And she got stuck with a bill for more than $100,000.\u00a0<\/p>\n
And then there\u2019s Kristin and Paul in Kansas City. They paid their bills upfront and then looked to get reimbursed\u2013 kept a spreadsheet. But when their claims finally got processed, the numbers didn\u2019t add up. Here\u2019s what they saw: Like pretty much every insurance plan, Kristin and Paul\u2019s had a \u201cdeductible\u201d\u2013 an amount they had to pay out of pocket before insurance would reimburse anything.\u00a0<\/p>\n
Kristin H: Then I started watching the deductible and you know, when I calculated my spreadsheet of how much we had paid out of pocket, and when we saw what was on like our out-of-network spend, those two weren\u2019t matching.\u00a0<\/strong><\/p>\n
Dan: <\/strong>She really couldn\u2019t figure this out.\u00a0<\/p>\n
Kristin H: I just kind of handed over all of my spreadsheets to Paul, and so that\u2019s when he started digging into the \u201cyour discount.\u201d\u00a0<\/strong><\/p>\n
Dan: \u201cYour discount\u2026\u201d That was this mysterious number on all the statements from the insurance company. In addition to the provider\u2019s rate, and what insurance might pay, the statements listed, quote, \u201cyour discount.\u201d\u00a0<\/p>\n
Paul H: And I\u2019m like, what is this? I don\u2019t understand why it\u2019s talking about a discount. We are paying cash out of pocket to the provider at their billed rate, and our insurance is saying that there\u2019s some sort of discount.\u00a0<\/strong><\/p>\n
Dan: <\/strong>After a bunch of phone calls, he figured it out: The discount was \u2026 the difference between the amount on the bill and what the insurance company\u2013 with MultiPlan\u2019s help\u2013 had decided was a \u201cfair price.\u201d\u00a0<\/p>\n
Paul H: For example, an occupational therapy bill that might be $125, this third party adjuster might come back and say, essentially what the market rate for that should be is $76. And so, your discount, quote, unquote, is $49.\u00a0<\/strong><\/p>\n
Dan:<\/strong> Except of course, it wasn\u2019t a discount for Kristin and Paul. They had already paid that $49, when they paid the provider upfront. Once Kristin and Paul learned what the \u201cdiscount\u201d actually meant, they started to understand who actually got the benefit\u2013 the insurer. Because \u2026\u00a0<\/p>\n
Kristin H: That discounted rate is actually what will be applied to your deductible. So you\u2019re not going to hit your deductible nearly as quickly as you think. Right? Because we\u2019ve essentially ignored half of your payment.\u00a0<\/strong><\/p>\n
Dan: <\/strong>This hits Kristin and Paul in two ways.\u00a0<\/p>\n
First, it means they\u2019re actually spending a lot more before their insurance kicks in. It also means that when their insurance does start reimbursing them a percentage of what they\u2019ve spent, the insurance is only paying a percentage of that lower amount. Overall, it means the reimbursements Kristin and Paul get are gonna be thousands of dollars less than they\u2019d expected.\u00a0<\/p>\n
I mean, it took a LOT of work for Kristin and Paul to figure this out. At one point, Paul posted to Reddit asking for help\u2013 that\u2019s where Chris Hamby found him. In Paul\u2019s post, he noted how nobody ever even mentioned this third-party adjuster\u2013 not until he had already talked to his insurance company for what he said was \u201cabout 18 times.\u201d Frequently on hold for 45 minutes or more.\u00a0<\/p>\n
Kristin says once they finally figured out what was going on, they could figure out how to budget for it. There were sacrifices. She stopped seeing one of her providers as often. But finally figuring out what was going on also allowed them to live with it.\u00a0<\/p>\n
Kristin H: The infuriating part was telling, like doing exactly what we were told to do, following the process, and then feeling like you are crazy. Like why, why doesn\u2019t this make sense? You know? And so I think I\u2019m fortunate that Paul just wouldn\u2019t let it die and was gonna research until he figured it out.\u00a0<\/strong><\/p>\n
Dan: <\/strong>You did all of the work, you tracked it down, you identified the problem, and you, as you say, kind of resigned yourself to it. You\u2019re like, okay, this Goliath is not\u2013 we don\u2019t have the slingshot for this. Goliath is stomping all over our town, and we have to live in that reality. Having the knowledge, having done that work, gives you, it sounds like, an ability to have some peace. Like having tracked it down means that this sucks, but it\u2019s not the same as living in a situation where like, now what? Like anything could happen.<\/p>\n
Kristin H: Yeah, you feel crazy or hopeless. You know? Like I\u2019ve done everything and this doesn\u2019t \u2026 So there\u2019s just the sense of like, am I missing something? You know, is there anything left for me to do? I recognize that everyone is not like this, but for me, knowledge is a gift.\u00a0<\/strong><\/p>\n
Dan: <\/strong>Chris Hamby says there\u2019s rarely a way to get this kind of knowledge in advance. He says you\u2019re unlikely to find these kinds of details in your insurance plan document.\u00a0<\/p>\n
Chris Hamby: It typically will not say when you go out of network, we\u2019re going to send your claim to a third party that you\u2019ve never heard of to price it. It will just give some sort of vague language about competitive rates in your geographic area. And if you call up in advance of seeking the care to try and get an estimate, most of the time you will not get much more specifics than that. They tell you you have to just go and they\u2019ll process the claim and you\u2019ll see when the explanation of benefits comes through.\u00a0<\/strong><\/p>\n
Dan:<\/strong> Yeah, and look, I hate to get you even angrier, but Chris says the rules can change on you, without notice.\u00a0<\/p>\n
Chris Hamby: A lot of people that I talk with also have seen no change in their insurance plan, but they\u2019ve seen their reimbursement rates decline over time.\u00a0<\/strong><\/p>\n
Dan: <\/strong>Turns out, behind the scenes, their insurance made a switch from a service like FAIR Health, which looks at what\u2019s getting paid in general, to a service like MultiPlan, which looks for the steepest possible price cuts.\u00a0<\/p>\n
Chris Hamby: And the difference between those two amounts can be vast. So you have people who in some cases stop seeing their doctors because their costs doubled almost overnight.\u00a0<\/strong><\/p>\n
Dan:<\/strong> Oh god. And still. Better to know. Better that as many of us know as possible. That\u2019s why Chris reviewed more than 50,000 pages of documents, and interviewed more than a hundred people for that story. And why lawyers for the New York Times helped get courts to agree to give him documents that had been under seal.\u00a0<\/p>\n
Kristin and Paul\u2013 who had figured most of this out for themselves\u2013 they definitely appreciated all that work.\u00a0<\/p>\n
Paul H: When Chris published the article that he did, it was very validating to know we\u2019re not the only ones who are in this same boat. And there\u2019s actually people who have had far worse experiences than ours. Like, ours kind of pale in comparison. And then immediately, like, within 24 hours to see 1,500 or 1,600 comments on the article talking about it. It\u2019s like, okay, I might not have the stone that can slay the giant, but maybe The NewYork Times has the right sling and they might have the right stone to at least start the conversation.\u00a0<\/strong><\/p>\n
Dan:<\/strong> A few weeks after Chris\u2019s article came out, U.S. Senator Amy Klobuchar sent the top federal antitrust regulators a letter: She wanted them to take a hard look at MultiPlan.\u00a0<\/p>\n
Chris Hamby: She expressed concern about the potential for price fixing here.\u00a0<\/strong><\/p>\n
Dan: <\/strong>Actually, Chris says some providers have already filed lawsuits against MultiPlan based on antitrust allegations.\u00a0<\/p>\n
Chris Hamby: The idea is that all the insurance companies outsource their pricing decisions to a common vendor. They\u2019re essentially fixing prices via algorithm is the allegation.\u00a0<\/strong><\/p>\n
Dan:<\/strong> As we noted here a few episodes ago, these antitrust regulators in the Biden administration have gotten pretty feisty. [That was the episode about the cyberattack on a company called Change Healthcare. It was called \u201cThe Hack,\u201d if you missed it. Pretty fun!]\u00a0<\/p>\n
And I mean, those antitrust regulators have their work cut out for them. And a lot of targets. But I do want to egg them on here. I suspect you do too. Meanwhile, you\u2019re egging US on.\u00a0<\/p>\n
Listener 1: The first thought that went through my head was I\u2019m going to fight this because this is absolutely ridiculous. I\u2019ve already paid for this.\u00a0<\/strong><\/p>\n
Dan: <\/strong>A few weeks ago, we asked you for stories about your experiences with sneaky fees, often called facility fees.\u00a0<\/p>\n
Listener 2: When the facility fee is twice the office visit fee, it\u2019s just crazy. I mean, it\u2019s a 10-minute appointment for a prescription.\u00a0<\/strong><\/p>\n
Dan:<\/strong> You came through, and now we\u2019re making some calls, digging in for more details, and learning so much. We\u2019re gonna have a sneak preview for you in a few weeks. Till then, take care of yourself.\u00a0<\/p>\n
This episode of An Arm and a Leg was produced by me, Dan Weissmann, with help from Emily Pisacreta and Claire Davenport\u2013 our summer intern. Welcome aboard, Claire!\u2013 and edited by Ellen Weiss. Adam Raymonda is our audio wizard. Our music is by Dave Weiner and Blue Dot Sessions. Gabrielle Healy is our managing editor for audience. Gabe Bullard is our engagement editor. Bea Bosco is our consulting director of operations. Sarah Ballama is our operations manager.\u00a0<\/p>\n
An Arm and a Leg is produced in partnership with KFF Health News. That\u2019s a national newsroom producing in-depth journalism about healthcare in America and a core program at KFF, an independent source of health policy research, polling and journalism. Zach Dyer is senior audio producer at KFF Health News. He\u2019s editorial liaison to this show.\u00a0<\/p>\n
And thanks to the Institute for Nonprofit News for serving as our fiscal sponsor, allowing us to accept tax-exempt donations. You can learn more about INN at INN.org. Finally, thanks to everybody who supports this show financially. You can join in any time at https:\/\/armandalegshow.com\/support\/<\/a><\/p>\n
Thanks for pitching in if you can, and thanks for listening.<\/p>\n
\u201cAn Arm and a Leg\u201d is a co-production of KFF Health News and Public Road Productions.<\/p>\n
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