In-Network, Complex COVID-19 Hospitalizations Cost More Than $128K

According to a new FAIR Health study, COVID-19 hospitalization cost varies by state, with complex hospitalizations for COVID-19 in-network average cost maxing out at $128,650. 

“Behind the numbers of our COVID-19 Cost Tracker are the individuals who have contracted COVID-19. As a public service, this brief provides a descriptive analysis of that patient population, offering context for the COVID-19 Cost Tracker,” stated FAIR Health President Robin Gelburd in a press release.

The study provides a state-by-state analysis of private healthcare claims from April 2020 to August 2021, displaying states with the highest and lowest average allowed amounts for each treatment pathway and average allowed amounts by the US census region.

In 2020 and 2021, New Jersey, California, Alaska, Nevada, and Arizona were the five states with the highest average allowed amount for COVID-19 complex hospitalizations. New Jersey was the highest at $128,650 for COVID-19 complex hospitalizations. 

The five states with the lowest average allowed amounts for complex hospitalizations for COVID-19 were Maryland, Arkansas, West Virginia, North Carolina, and Kentucky. Maryland was the lowest at $49,127 for COVID-19 complex hospitalizations.

The study defines complex hospitalizations for COVID-19 as hospitalizations that require ventilation and/or admission to the intensive care unit (ICU). Non-complex hospitalizations do not require such treatments. 

The state with the highest average allowed amount for non-complex COVID-19 hospitalization is Alaska, at $44,239. However, Nevada, California, Wyoming, and New Jersey were also in the top five for the highest allowed amounts for COVID-19 non-complex hospitalizations. 

The state with the lowest average allowed amount for COVID-19 non-complex hospitalization was Maryland at $12,531. However, the study also mentioned Arkansas, Michigan, West Virginia, and Kentucky had the lowest COVID-19 amounts for COVID-19 non-complex hospitalizations.

Nevada’s highest average allowed amount for COVID-19 outpatient treatment was $1,538.

The report showed five states with the lowest average allowed amounts for outpatient treatment for COVID-19 were Maryland, West Virginia, Delaware, Utah, and Vermont.

Once more, Maryland was the state with the lowest average allowed amounts for outpatient treatment for COVID-19 at $580. 

Overall, the study showed that COVID-19 costs varied by region and state. 

“For complex and non-complex hospitalizations, the West had the highest average allowed amounts and the South the lowest. For outpatient treatment, the West had the highest average allowed amounts and the Northeast the lowest,” the report explained. 

In the West, the average allowed amount was $117 316 was complex inpatient treatment, $38,135 for non-complex inpatient treatment, and $1,187 for outpatient treatment. 

In the South, the average allowed amount for complex inpatient treatment t was $84,324, $20,013 for non-complex inpatient treatment, and $954 for outpatient treatment.

Additionally, in the Northeast, the average allowed amount for complex inpatient treatment was $106,282, $35,735 for non-complex inpatient treatment, and $937 for outpatient treatment. 

This study also offered several other key findings, including information on the median length of stay, diagnosis rate, and type of comorbidities.

From April to August 2021, December 2020 was the month with the most COVID-19 diagnoses, with a reported 549,083 patients diagnosed with the virus. 

The analysis also discovered that the percentage of index date diagnoses varied by location. For example, 9.6 percent of all rural diagnoses occurred in October 2020, compared to 7.1 percent of all urban diagnoses in that month. 

The distribution of COVID-19 diagnoses in urban areas was higher compared to rural areas from January to June 2021. 

However, in July 2021 and August 2021, rural areas had a higher distribution of COVID-19 cases than urban areas.

The analysis also showed that the median length of stay for patients with a complex hospitalization for COVID-19 has declined from the beginning of the pandemic.

The median length of stay went from 13 days in April 2020 to 7 days in July 2021 for patients with a complex hospitalizations.

In addition, the median length of stay for a non-complex hospitalization for COVID stayed between three to four days. 

The study noticed patients the distribution of comorbidities in non-complex hospitalizations changed from that found in patients with a complex hospitalization.

Of COVID-19 patients with complex hospitalization for COVID-19, 14.7 percent had comorbidity of hyperlipidemia or hypertension. 

 The most common comorbidity of non-complex hospitalization for COVID-19 was associated with chronic breathing issues, such as asthma and chronic obstructive pulmonary disease, at 6.5 percent of the distribution.