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.
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