Coronavirus: Study estimates patient treatment costs

March 18, 2020

The study looked at spending on hospital admissions for pneumonia and found out-of-pocket costs for insured patients can reach $1,396.

A new study finds that the cost of COVID-19 coronavirus patients may reach more than $20,000.

The March 13 study, from the Peterson Center on Healthcare and the Kaiser Family Foundation, looked at typical spending for hospital admissions in 2018 for three diagnosis-related groups for pneumonia without complications or comorbidity, pneumonia with complications or comorbidity, and pneumonia with complications and comorbidity among people under the age of 65 with large employer healthcare plans.

The authors found that the average total costs of admissions, which are paid by a combination of the insurance plan and the patient’s out-of-pocket costs, for a patient with pneumonia, major complications, and comorbidity is $20,292. They also note that costs vary widely across the country with treatment ranging from $11,533 to $24,178.

For patients without major complications the costs fall with an average of $13,767 for patients with less serious complications or comorbidities and $9,763 for patients without any complications or comorbidities, the study says.

Much of these costs are handled by the insurance companies, but 82 percent of patients covered by insurance have a deductible that must be paid before the insurance will pay and 52 percent have a deductible over $1,000. The average deductible of an employer sponsored insurance plan is $1,396, the study says.

The average out-of-pocket cost of admission for pneumonia without complications or comorbidities is $1,464 and the cost is slightly less for patients with major complications, but the researchers warn that the out-of-pocket costs for COVID-19 treatment can be higher. This is due to many patients having higher deductibles, the pandemic is hitting before many people have hit their deductible for the year, and the analysis does not include direct billing from out-of-network providers.

“Medical costs are already a common concern in the U.S., particularly for people without insurance, those with high deductibles, and those in worse health. In the context of the COVID-19 pandemic, it is of even greater concern, as many people could be incurring high out-of-pocket costs, at a time when there is also risk of a recession,” the researchers wrote.

The world continues to reel from the coronavirus pandemic with little relief in sight. The virus has officially hit all 50 states as West Virginia reported their first positive test March 17 and the U.S. death toll has surpassed 100. Globally, 200,000 people have been infected in at least 44 countries as nations close their borders in an effort to stem the pandemic, according to reporting from The New York Times.

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