Out-of-pocket costs for hospitalizations rise dramatically

Money man.

Commercially insured patients have seen their out-of-pocket costs increase dramatically in just a four-year period.

Researchers at the University of Michigan studied 7.3 million medical claims from Aetna, UnitedHealthcare and Humana for hospitalizations that occurred between 2009 and 2013, with a focus on seven common inpatient medical procedures. They included treatment of acute myocardial infarction, live births, pneumonia, appendicitis, coronary artery bypass graft, knee joint replacement and spinal fusion surgery.

The researchers concluded that out-of-pocket costs for hospitalizations rose 37 percent during that time, according to their research, which was published in JAMA Internal Medicine. Patients had an average out-of-pocket cost for a hospitalization of $738 in 2009; it rose to $1,013 by 2013.


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However, enrollees in individual health coverage plans had the highest out-of-pocket costs at $1,875--more than 80 percent higher than the average. Consumer-directed health plans had average out-of-pocket costs of $1,219, more than 20 percent higher than the study average.

Much of the increase was connected to a dramatic rise in amounts being applied to a patient's deductible, according to the study. That rose 86 percent during the study time period, from $145 to $270 by 2013. Co-payments rose by 33 percent during that same time, from $518 to $688.

The data appears to dovetail with a recently completed survey by TransUnion that also concluded that patient out-of-pocket costs have risen dramatically, putting pressure on some providers to determine how they would collect payments. At the same time, pressure has also mounted on hospitals to provide more price transparency to patients in order to provide them more specific costs for their care.

However, another recent study has concluded that many health plan enrollees are paying less out-of-pocket for pharmaceuticals, even as prices for many products have risen by multiples in recent years.

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