1 in 7 patients receive surprise medical bills, HCCI study shows

About 1 in 7 patients received a surprise bill in 2016 after being treated by an out-of-network healthcare professional at an in-network facility, according to a report from the Health Care Cost Institute.

For the report, the institute used its commercial claims database to examine about 620,000 in-network inpatient admissions and associated professional claims (both in- and out-of-network claims filed by the physician or other healthcare professional who provided care) in 37 states and Washington, D.C., in 2016.

Three findings:

1. The institute found that 14.5 percent of in-network hospital admissions had at least one associated out-of-network professional claim in 2016. This means about 1 in 7 patients received care at an in-network hospital and still received a surprise out-of-network bill.

2. Surprise billing varied by state. The share of in-network hospital admissions with at least one associated out-of-network professional claim was 26.3 percent in Florida (highest) vs. 1.7 percent in Minnesota (lowest).

3. Anesthesiology was the specialty with the largest share (16.5 percent) of surprise out-of-network bills.



More articles on healthcare finance: 

Montefiore Health System CFO Colleen Blye on her daily mantra and facing today's healthcare challenges
10 recent stories about surprise medical bills
Georgia nonprofit hospitals could face new financial transparency rules

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