Dallas emergency medical spending down 52% since No Surprises Act

Dallas, September 3, 2026, A new analysis by HaloMD has shown that out-of-network (OON) emergency medical spending has decreased by up to 52% since the No Surprises Act (NSA) took effect in January 2022. The study, which draws from multiple sources including the Brookings Institution and CMS data, estimates that nearly $1 billion in annual savings has been realized even under the most conservative assumptions.

Patrick Velliky, Chief External Affairs Officer at HaloMD, commented, "The NSA has effectively protected patients from unexpected out-of-network bills, but this analysis highlights that it has also significantly lowered overall medical costs."

The research analyzed data from emergency medicine claims subject to the NSA, comparing pre-NSA spending of approximately $641.71 per claim with post-NSA spending across various resolution pathways. The analysis found that OON emergency spending declined by 13% to 52%, depending on the payment rates for claims not resolved through formal arbitration.

Key findings include: - Approximately 76% of NSA-eligible claims were resolved by the insurer's initial payment in 2024, with only 9.5% of OON emergency medicine claims proceeding to formal independent dispute resolution (IDR) in 2025. - The mean 2025 IDR award for emergency medicine was around $630 per claim, which closely mirrors the pre-NSA baseline of about $642. - Applied to the roughly 11.9 million OON emergency medicine claims subject to the NSA, the model estimates annual savings of $978 million to $3.95 billion compared to pre-NSA levels.

Alla LaRoque, President and CEO of HaloMD, stated, "The data clearly show that when the entire out-of-network payment system is considered, arbitration is a minor part of the overall picture. Today, patients are spending less on emergency medical care because of the No Surprises Act."

These findings have significant implications for ongoing discussions about the NSA. The analysis suggests that the law has not only protected patients from unexpected bills but has also reduced overall medical spending. The study emphasizes the importance of considering the broader impact of the NSA, including claims resolved through initial payment or open negotiation, rather than focusing solely on IDR awards.

HaloMD's methodology involved establishing a pre-NSA OON baseline using historical data and then modeling post-NSA spending across different payment pathways. The analysis evaluated three scenarios for claims resolved outside IDR, comparing them to the pre-NSA baseline to calculate estimated annual savings.

HaloMD, the leading provider of Independent Dispute Resolution (IDR) services, supports healthcare providers across 50 states and Washington, D.C., navigating the federal No Surprises Act and state balance-billing laws. The company uses proprietary technology, advanced analytics, and deep specialty expertise to promote fair reimbursement, long-term financial sustainability, and high-quality patient care.