Part II: An Economist's Take on Surprise Billing and Healthcare Payment Reform with Dr. Lisa Grabert

What happens when healthcare payment systems no longer reflect the services providers actually deliver? In this Clarity Special Edition, recorded live from the fifth annual Clarity Summit in Laguna Beach, California, Asbel Montes sits down with Dr. Lisa Grabert — healthcare economist, visiting research professor at Marquette University, and nationally recognized expert on Medicare reimbursement policy — for a conversation that is equal parts personal, analytical, and urgent. Dr. Grabert doesn't just study healthcare policy. She's lived its consequences. In this episode, she shares her own mother's experience as a surprise billing victim — fully insured under Medicare, yet sent to collections before the family even knew a bill existed. That story opens a deeper discussion about what's working, what isn't, and what policymakers still need to fix. This conversation covers the No Surprises Act, ambulance payment reform, healthcare transparency, the prospective payment system, and the growing role of AI in policy research and healthcare decision-making. What you'll hear in this episode: How surprise billing continues to impact Medicare beneficiaries despite recent reforms — and why Congress may need to revisit the No Surprises Act Why 20% of Medicare Advantage enrollees switch plans annually — and what that means for provider billing and patient protection Why transparency, not just legislation, may be the most powerful tool for healthcare accountability What the ground ambulance data collection results mean for the future of EMS reimbursement Why some healthcare economists favor moving beyond the fee schedule to a prospective payment system — and what a budget-neutral, phased transition could look like Why EMS providers treating patients without guaranteed reimbursement is a systemic design flaw — not a compliance issue How Dr. Grabert uses AI to replace months of data cleaning work in 24 to 48 hours — and why she tells her students that ignorance is now a choice What healthcare leaders should be thinking about as AI becomes a standard research and policy tool The bottom line: Healthcare reform is rarely simple. But transparency, thoughtful payment policy, and better use of data remain essential to building a more accountable and sustainable healthcare system. Dr. Grabert challenges leaders to think beyond short-term fixes — and toward payment models that actually reflect the value providers deliver.   If you're a healthcare executive, EMS leader, policymaker, physician, researcher, or healthcare finance professional trying to understand where payment reform is heading next, this episode is for you. Subscribe to The Leadership Lab with Asbel Montes for conversations at the intersection of healthcare leadership, finance, technology, and systems-level thinking.   Links: Asbel Montes LinkedIn - https://www.linkedin.com/in/asbel-montes-31027634 Dr. Lisa Grabert LinkedIn - https://www.linkedin.com/in/dr-lisa-grabert-78ab527/    Solutions Group Services: LinkedIn - https://www.linkedin.com/company/solutionsgroupservices  Instagram - https://www.instagram.com/solution_sgroup/  Facebook - https://www.facebook.com/solutionsgroupservices  Website -  ​​https://www.solutionsgroup.com/