No Surprises Act Trims Out-of-Network Emergency Costs by Up to 52%

The analysis indicates that out-of-network emergency medicine spending dropped between 13% and 52% compared to pre-law baselines. While much of the public debate surrounding the legislation has centered on the independent dispute resolution process, the data suggests that the vast majority of claims—roughly 90%—are settled long before reaching that stage. In 2024, insurers resolved 76% of eligible claims through initial payments, while only 9.5% of cases proceeded to formal arbitration in 2025.

Patrick Velliky, Chief External Affairs Officer at HaloMD, noted that the research confirms the law is achieving its secondary goal of lowering total medical costs. By comparing current spending against a pre-NSA baseline of approximately $642 per claim, the firm estimates annual savings ranging from $978 million to nearly $4 billion. These findings arrive as Congress considers potential refinements to the law, providing a broader perspective on how initial payment negotiations, rather than just arbitration awards, dictate the actual financial impact on the healthcare system.