New York had most out-of-network charges for in-network inpatient stays in 2017

New York, New Jersey, Texas and Kansas had the highest prevalence of out-of-network charges for in-network inpatient admissions in 2017 for people with large employer health plans, according to a study from the Kaiser Family Foundation.

Prevalence of out-of-network charges for in-network inpatient admissions was lowest in South Dakota, Nebraska and Minnesota.

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 under age 65. 

Several states had insufficient data, including Oregon, Idaho, Wyoming, Vermont and Louisiana.

Here is the share of in-network inpatient admissions 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.

New York: 33 percent

New Jersey: 29 percent

Texas: 27 percent

Kansas: 27 percent

Florida: 24 percent

Arizona: 23 percent

Nevada: 19 percent

Oklahoma: 18 percent

California: 18 percent

Georgia: 16 percent

Colorado: 15 percent

New Mexico: 14 percent

Maryland: 14 percent

Tennessee: 13 percent

Michigan: 13 percent

Virginia: 13 percent

Alabama: 11 percent

Pennsylvania: 11 percent

Arkansas: 10 percent

Missouri: 10 percent

New Hampshire: 9 percent

Illinois: 9 percent

West Virginia: 9 percent

Connecticut: 9 percent

Massachusetts: 8 percent

Ohio: 8 percent

North Carolina: 8 percent

Utah: 8 percent

Rhode Island: 8 percent

Washington: 7 percent

Montana: 7 percent

Wisconsin: 7 percent

Indiana: 7 percent

Kentucky: 7 percent

Mississippi: 6 percent

Maine: 5 percent

Iowa: 4 percent

South Dakota: 2 percent

Nebraska: 2 percent

Minnesota: 2 percent

 

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