Hospitals that are for-profit and have a higher proportion of uninsured Hispanic/Latino patients have, on average, more expensive self-pay emergency department visits, according to a study in The American Journal of Managed Care.
Researchers at the University of Maryland in Baltimore and the University of Michigan in Ann Arbor analyzed ED facility fees using data from Turquoise Health, a healthcare price transparency company. They analyzed all CMS-certified hospitals required to comply with the federal Hospital Price Transparency rule and provided ED services from September 2021 to September 2023.
Besides Maryland and Minnesota, which regulate self-pay hospital rates, U.S. hospitals “have broad discretion in setting self-pay prices, which could be used to offset financial strain from both COVID-19 and other financial pressures,” the authors wrote.
The study, published Dec. 4, included 4,408 U.S. hospitals. Here are three key findings:
1. From 2021 to 2023, mean self-pay ED facility fees increased across five complexity levels, particularly among high-acuity cases. For level 3 visit complexity, mean prices rose $98.69. Level 4 visits noted an increase of $392.85 and level 5 grew $642.74.
2. Price growth was more prominent at for-profit hospitals, as level 5 costs increased more than $2,100 at for-profit facilities, compared to $385.55 at nonprofit hospitals and $216.84 at public hospitals.
3. “Hospitals in areas with higher proportions of uninsured Hispanic/Latino individuals increased self-pay prices more for level 4 and 5 visits than hospitals in other areas,” the researchers said. For every 1% increase in a hospital’s uninsured Hispanic/Latino population, the mean self-pay ED visit price increased $89.38 for level 4 visits and $166.17 for level 5.
