- There's an almost $80,000 difference between the highest and lowest in-network costs for complex COVID-19 hospitalizations in different U.S. states, illustrating the stark disparities in health prices depending on where a patient lives, according to a new analysis of private claims data.
- New Jersey has the highest in-network costs for complex hospitalizations from COVID-19 of any U.S. state, at $128,650, nonprofit Fair Health said. Maryland, which uses an all payer model, had the lowest at $49,127.
- The analysis illustrates the high financial toll of severe coronavirus infection — along with its health costs. Fair also found almost half of COVID-19 patients with complex hospitalizations had five or more comorbidities.
The pandemic has proved a huge stressor not just on the nation's public health infrastructure, but also on its finances. Healthcare already consumed a broad swath of U.S. spending and was a major source of pressure on Americans' pocketbooks, with a staggering one in five people saying they'd be unable to afford medical care in an emergency.
Add on top of that the cost of a potential COVID-19 hospitalization. Even noncomplex cases are pricey, with one previous study pegging the median cost of a single hospitalization — not including follow-up care — at almost $14,400.
The new analysis illustrates how complex COVID-19 hospitalizations — defined by Fair as those that require ventilation or admission to the intensive care unit — make an even greater financial dent. But the size of the hit depends on where patients are admitted.
Fair Health conducted a state-by-state analysis of private healthcare claims data from April 2020 to August 2021, finding stark differences in COVID-19 inpatient costs by state. That allowed amount is the payment negotiated between an insurance plan and a provider. It includes both the portion paid by the plan member and the portion covered by the payer.
New Jersey has the highest in-network costs for complex COVID-19 inpatients
Along with being the state with the lowest average allowed amounts for complex hospitalizations, Maryland had the lowest in-patient averages for noncomplex stays, at $12,531, and outpatient treatment, at $580.
This could be partly explained by Maryland's all-payer rate-setting system, Fair Health researchers said. In Maryland, hospital rates are regulated by an independent state body, and all payers are charged the same rate for the same service at the same facility.
Meanwhile, the state with the highest average allowed amount for noncomplex COVID-19 hospitalizations was Alaska, at $44,239. The state with the highest average allowed amount for outpatient COVID-19 treatment was Nevada, at $1,538.
Following a summer surge in COVID-19 cases due to the highly infectious delta variant, hospitalizations and deaths have increased. Over the past two weeks, hospitalizations have jumped by 22%, according to a tracker maintained by the New York Times.
Data from the Centers for Disease Control and Prevention shows that unvaccinated people are at a much greater risk to test positive, have a severe case of, or die from COVID-19. Despite that fact, the U.S. is struggling to combat persistent vaccine hesitancy in some groups, even as hospitals in some regions once again strain to treat an influx of COVID-19 patients.
There is some evidence that hospitals may be better handling COVID-19 cases after almost two years of experience with the disease and due to the rise of new therapies, including remdesivir.
The median length of stay for patients with a complex hospitalization for COVID-19 decreased from a high of 13 days in April 2020 to a low of 7 days in July 2021, Fair Health found. However, the median length of stay for a noncomplex hospitalization remained relatively flat throughout this period.
Rising COVID-19 cases have stressed hospital's operations, though. In the third quarter, U.S. hospitals and health systems were slammed by the delta variant, with an influx of new and higher-acuity patients contributing to starkly rising expenses that, in many cases, outpaced revenue growth.
Fair Health's analysis also outlined the high number of COVID-19 comorbidities, especially among severe cases.
Of COVID-19 patients with a complex inpatient stay, more than 48% had five or more comorbidities, while about 21% had zero comorbidities. By comparison, patients with zero comorbidities made up nearly half of all patients diagnosed with the disease.