“Hidden” costs of hospitalization for privately insured adults rose more than 37 percent over five years, with patients paying more than $1,000 on average by 2013, researchers found.
These hikes came in the form of deductibles, patient co-pays and so-called “co-insurances,” or percentages of final costs.
“People expect that under-insured or uninsured people will often face big hospitals bills, but a lot of people probably think that if they have high-quality insurance they’re OK,” said study author Emily Adrion.
“We found that between the co-payments that the better-insured have to make right when they walk in the door, and the deductibles they have to reach before any insurance actually kicks in, and the percentage of the cost of care that 85 percent of patients are still responsible for even after insurance kicks in, the final bill is high and getting higher,” she said.
Adrion is a research fellow with the Center for Healthcare Outcomes and Policy at the University of Michigan Medical School, in Ann Arbor.
For the study, investigators analyzed data from the Health Care Cost Institute concerning 7.3 million hospital medical claims filed between 2009 and 2013. This was before the Affordable Care Act took effect.
The claims were processed by one of three major health insurers who cover patients in all 50 states: Aetna, UnitedHealthcare and Humana.
The team looked at expenses accrued by hospitalized adults aged 18 to 64. Billings for seven common reasons for hospitalization were also examined: heart attack, childbirth, pneumonia, appendicitis, heart bypass surgery, total knee replacement and spinal fusion.
The result: Out-of-pocket costs averaged $1,013 in 2013, up from $738 at the start of the study.
Patients with individual market plans fared the worst. The study found they were stuck with an average bill of $1,875 per hospitalization by 2013, followed by roughly $1,200 for those with consumer-directed health plans. These plans generally allow more consumer decision-making, often with health savings accounts alongside high deductibles.