How states rank for out-of-network ER billing

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Texas, New Mexico, New York, California and Kansas had the highest prevalence of out-of-network emergency room billing in 2017 for people with large employer health plans, according to a recent study from the Kaiser Family Foundation.

Prevalence of out-of-network billing in emergency settings was lowest in Minnesota, South Dakota, Nebraska, Alabama and Mississippi.

To determine the incidence of surprise medical bills, researchers examined large employer claims data from IBM’s MarketScan Research Database, representing claims and encounters for nearly 19 million people. 

Several states had insufficient data, including Oregon, Idaho, Louisiana and South Carolina.

Here is the share of ER visits with at least one out-of-network charge in 2017, for 40 states, among people with large employer plans. They are listed from highest to lowest.

1. Texas – 38 percent

2. New Mexico – 29 percent

3. New York – 28 percent

4. California – 26 percent

5. Kansas – 24 percent

6. New Jersey – 24 percent

7. Florida – 22 percent

8. Oklahoma – 20 percent

9. Tennessee – 20 percent

10. Nevada – 18 percent

11. Ohio – 18 percent

12. Maryland – 18 percent

13. New Hampshire – 17 percent

14. Rhode Island – 16 percent

15. Arizona – 16 percent

16. Utah – 16 percent

17. Colorado – 15 percent

18. Washington – 14 percent

19. Massachusetts – 14 percent

20. Georgia – 13 percent

21. Arkansas – 12 percent

22. Virginia – 12 percent

23. Illinois – 12 percent

24. Pennsylvania – 12 percent

25. Wisconsin – 12 percent

26. North Carolina – 11 percent

27. West Virginia – 10 percent

28. Connecticut – 10 percent

29. Michigan – 9 percent

30. Missouri – 9 percent

31. Indiana – 8 percent

32. Montana – 8 percent

33. Iowa – 8 percent

34. Kentucky – 8 percent

35. Maine – 7 percent

36. Mississippi – 6 percent

37. South Dakota – 4 percent

38. Alabama – 4 percent

39. Nebraska – 4 percent

40. Minnesota – 3 percent

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