An analysis of large employer health plan claims data by Kaiser Health Foundation found that millions of emergency visits and hospital stays left people with large employer coverage at risk of a surprise bill in 2017. Their analysis of large employer health plan claims found that potential surprise medical bills are a common problem – affecting 18% of emergency care visits and 16% of in-network inpatient stays. The rate of these potential surprise bills varies from state-to-state, with Texas, New York, Florida, New Jersey, and Kansas having among the highest rates of out-of-network charges associated with both emergency care and in-network hospital stays among people with large employer coverage. Minnesota, South Dakota, Nebraska, Maine, and Mississippi, by contrast, had among the lowest rates of out-of-network charges for both emergency and in-network hospital care for people with large employer coverage. The incidence of surprise medical bills in small group or non-group health plans may be different and was beyond the scope of this study.
- An examination of surprise medical bills and proposals to protect consumers from them: https://www.healthsystemtracker.org/brief/an-examination-of-surprise-medical-bills-and-proposals-to-protect-consumers-from-them/