Date of Award
Spring 5-1-2026
Document Type
Thesis
Degree Name
Master of Arts (MA)
Department
Economics
First Advisor
Partha Deb
Second Advisor
Matthew Baker
Academic Program Adviser
Matthew Baker
Abstract
The No Surprises Act (NSA) removed patients from responsibility for out-of-network surprise medical bills. In its place, the NSA established an independent dispute resolution (IDR) process through which providers and insurers submit competing payment offers to an arbitrator, who selects one offer in full. Using the universe of federal air ambulance IDR disputes from Q1 2023 through Q2 2025 (57,368 dispute line items), I examine whether provider ownership structure and enforcement jurisdiction jointly predict arbitration outcomes. The two outcomes, whether the provider offer prevails, and how large that prevailing offer is relative to the benchmark payment rate, the Qualifying Payment Amount (QPA), tell an asymmetric story. The probability that the provider offer prevails is uniformly high (87.14% overall) and does not vary meaningfully across ownership type or enforcement regime. The size of prevailing offers varies substantially: private equity (PE)-controlled providers submit prevailing offers that are on average 3.891×QPA under shared enforcement, compared with 1.839×QPA for nonprofit and government providers, and this gap is largest where enforcement responsibility is most divided.
Recommended Citation
Readman, Peter, "Private Equity, State Enforcement, and Arbitration Outcomes Under the No Surprises Act: Evidence from Air Ambulance Disputes" (2026). CUNY Academic Works.
https://academicworks.cuny.edu/hc_sas_etds/1523
