Patients put in out-of-network care situations frequently, analysis finds

About 9 percent of elective inpatient admissions resulted in at least one out-of-network medical bill in 2014, according to research highlighted on Aug. 1 by the USC-Brookings Schaeffer Initiative for Health Policy.

The analysis examines studies on surprise billing published in medical journals and data from government organizations to better understand how frequently patients are put into situations that can lead to a surprise bill.

Specifically, researchers examined a Federal Trade Commission study published in Health Affairs in January 2017; a Government Accountability Office study published in March; and a study published in the New England Journal of Medicine in November 2017.

The analysis noted that 69 percent of air ambulance transports for privately insured patients were out-of-network in 2017. Additionally, about 20 percent of hospital emergency department visits resulted in at least one out-of-network bill in 2014.


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