Texas

By Sean Anderson, senior associate, Partners Real Estate When Congress passed the No Surprises Act (NSA) in December 2020, the goal was straightforward: protect patients from the exorbitant, unpredictable bills that had become synonymous with emergency care and rein in some of the pricing power that out-of-network physicians and freestanding facilities had come to enjoy. On paper, the law delivered. By requiring that out-of-network emergency treatment be billed at the same rate a patient would owe for in-network care, the NSA eliminated an estimated 10 million surprise bills in just the first nine months of 2023 and pushed down the overall cost of emergency room (ER) procedures across the board, according to the second annual report to Congress from the U.S. Department of Health and Human Services. For patients, it was an unambiguous win. For the physician groups and real estate operators that had built business models around emergency medicine, however, the law landed as a direct hit to the bottom line. Out-of-network reimbursements initially fell by roughly 40 percent, according to an FTI Consulting analysis of the provider side of the law, and bankruptcy filings for healthcare operators hit their highest level in five years, tripling from 2021 to …