From Health Affairs:
Some Emergency Department Patients Receive Unexpected Bills Afterward
Bethesda, MD—Surprise medical bills—an unexpected bill from an out-of-network provider or a bill from an out-of-network provider not chosen by a patient—have been in the news recently. A new study, released by Health Affairs as a Web First, found that in 2014, 20 percent of US hospital inpatient admissions originating in the emergency department (ED), 14 percent of outpatient visits to the ED, and 9 percent of elective inpatient admissions likely led to a surprise medical bill. This is a decrease from 2007 when those rates were nearly 28 percent, 18 percent, and 14 percent, respectively. The data evaluated were for 2007–14 and came from the Truven Health MarketScan Commercial Claims and Encounters Database. The authors reviewed claims for nonelderly patients with employer-sponsored health insurance.
Other key study findings:
The likelihood of receiving a surprise medical bill increased with a patient’s age and the complexity of his or her diagnosis.
Surprise medical bill rates for ED patients differed significantly across states, with the some of the highest 2014 rates in Florida (37 percent), New York (35 percent), and Texas (34 percent) (see the exhibit below).