I wrote Hacking Healthcare for Orielly, created ClearHealth, yada yada... Devil is always in the details of these rules but on the surface it looks like a good

I wrote Hacking Healthcare for Orielly, created ClearHealth, yada yada... Devil is always in the details of these rules but on the surface it looks like a good attempt. It is a sort of a bandaid though. To understand why this occurs know that most jurisdictions have certain staffing requirements for service lines. You must have X many neurologists covering X shifts. There is almost universally a shortage of these folks for other reasons, so you end up with a lot of non-staff doctors to fill the coverage requirements. Those non-staff often have different insurance relationships than staff doctors and so are "out of network". The two serious changes that would have a more durable impact on this are to free the lock the AMA has on residencies that exacerbates doctor shortages and to dramatically streamline the way insurance program enrollment is done for doctors. Further opening up interstate health insurance would also probably help.