News: Average complex COVID-19 hospital stay cost insurers $320 thousand

CDI Strategies - Volume 15, Issue 44

The average cost billed to private insurances for a complex COVID-19 hospitalization was $317,810, according to new data from FAIR Health. Alternately, the average estimate allowed amount for in-network providers for a complex COVID-19 hospital stay was $98,139—meaning the average cost for a complex stay was more than three times greater than the allowable amount.

For a general COVID-19 hospitalization, the average charge amount was $74,591 with an average estimated allowed amount of $33,525. Alternately, for COVID-19 non-hospitalization cases, the average charge amount was found to be $2,557 with an estimated allowed amount of $1,008.

COVID-19 hospitalization with complexities includes:

  • Laboratory tests
  • Durable medical equipment, such as ventilators
  • Blood and blood components
  • Treatments and specialty drugs
  • Radiology
  • ICU room and board
  • Outpatient and provider services (follow-up office visits, lab tests, radiology services, echocardiography procedures, immunology procedures, and transfusions)

General hospitalization for COVID-19 includes:

  • Laboratory tests
  • Radiology
  • Room and board
  • Treatments and specialty dugs
  • Outpatient and provider services (follow-up office visits, lab tests, immunology procedures, radiology services, echocardiography procedures, and oxygen and respiratory equipment)

Non-hospitalization COVID-19 cases include:

  • Laboratory tests
  • Radiology
  • Office visits
  • Cardiography procedures

FAIR Health plans to launch a free COVID-19 cost tracker in October 2021 using data from this report to allow viewers to see state-level cost estimates for the three categories mentioned above.

Editor’s note: The FAIR Health data can be found here.

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