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Analysis of Large Employer Health Plan Claims Found Potential Surprise Medical Bills a Common Problem

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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.

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