As COVID-19 continues to spread across the U.S., its impact on the U.S. health system is without precedent, with direct and indirect medical costs estimated to be in the hundreds of billions of dollars.
On an individual basis, cost estimates from the Peterson Center on Healthcare and Kaiser Family Foundation (KFF) range from between $10,000 to $90,000 per person depending on level of complications, ventilator use, etc.
The American Hospital Association estimates that American hospitals incurred more than $202 billion in losses between March 1st and June 30th — or more than $50 billion a month — from a combination of reduced revenue and increased costs.
Who is left to foot the final bill — and just how much of it — is one of the biggest unresolved questions, especially given the country’s unique patchwork system of health care delivery networks, range of insurance plans and variable policy priorities.
The Nasty Shock of ‘Surprise Billing’
Not only does America’s fragmented health care delivery system complicate billing and reimbursement, but insurer distinctions between in-network and out-of-network care often make it much more challenging. One example that is particularly relevant in the age of COVID-19 is so-called surprise billing, which often arises in an emergency situation when a patient has no ability to select the emergency room, treating physicians or ambulance providers.
According to the Peterson Center on Healthcare and KFF, for people in large employer plans, 18% of all ER visits and 16% of in-network hospital stays had at least one out-of-network charge associated with care in 2017.
While this varies by state, patients in Texas, New York, Florida and New Jersey were more likely to experience these surprise bills. As these states have some of the highest rates of COVID-19 infections and hospitalizations, the risk of actual costs becoming much higher is significant in these states, as well as more broadly across the country.
Furthermore, staggering and sustained unemployment levels warn of a much larger looming impact as the prospects grow that millions of Americans will soon be, if they aren’t already, without proper insurance coverage to afford care. In fact, data from over 800 hospitals in March found that levels of bad debt and charity care had already increased 13% over the previous year and is only expected to worsen with wider losses in coverage.
Temporary Legislative Interventions
Swift action by Congress and the easing of regulations by the Food and Drug Administration and Centers for Medicare & Medicaid Services have created a baseline level of support across COVID-19 testing and treatment. Collectively, $175 billion in provider relief was allocated via the Coronavirus Aid, Relief, and Economic Security Act in addition to the Paycheck Protection Program and Health Care Enhancement Act.
This article was originally published on BRINK News