National Average Charge for a Complex Hospital Stay for COVID-19 Is $317,810, FAIR Health Finds
Average Estimated Allowed Amount Is $98,139
NEW YORK, NY—September 21, 2021—The average billed charge for a complex COVID-19 hospitalization in the United States is $317,810, according to new cost estimates from FAIR Health. The average estimated allowed amount (the total amount paid to an in-network provider, including payments from both the plan and the patient) is $98,139. This cost information can be found in the latest release of FH® Total Treatment Cost benchmarks for COVID-19. Next month, similar values at the state level will be available through a free COVID-19 cost tracker on fairhealth.org.
Launched in November 2020, FH Total Treatment Cost COVID-19 benchmarks provide cost estimates for beginning-to-end treatment pathways for COVID-19, illuminating typical total costs for diagnosis and for professional and facility services associated with treating the disease. The product includes estimates of typical costs for three different designations of severity of COVID-19 care: hospitalization with complexities (such as intensive care unit [ICU] or ventilator), general hospitalization and non-hospitalization. For each, the median and average charge amount and estimated allowed (in-network) amount are given.
The chart below provides the latest national numbers on estimated costs for COVID-19, updated in FH Total Treatment Cost in September 2021:
Though not depicted here, the COVID-19 cost benchmarks—based on a current, 12-month window of claims, refreshed twice yearly—are organized into mean, 50th and 80th percentiles and grouped into 493 geozips—geographic areas generally based on the first three digits of a zip code—allowing national and local comparisons. The data come from FAIR Health’s immense database, the largest repository of private healthcare claims in the nation.
COVID-19 hospitalization with complexities includes, but is not limited to, hospital inpatient services such as laboratory tests, durable medical equipment (such as ventilators), blood and blood components, treatments and specialty drugs, radiology and ICU room and board, as well as outpatient and provider services such as follow-up office visits, lab tests, radiology services, echocardiography procedures, immunology procedures and transfusions. The second category, general COVID-19 hospitalization, includes, but is not limited to, hospital inpatient services such as lab tests, radiology, room and board, treatments and specialty drugs, as well as outpatient and provider services such as follow-up office visits, lab tests, immunology procedures, radiology services, echocardiography procedures, and oxygen and respiratory equipment. Lastly, the COVID-19 non-hospitalization category includes labs, radiology, office visits and cardiography procedures.
Separately, in October, FAIR Health will launch a free COVID-19 cost tracker on its website using data from FH Total Treatment Cost. Interactive maps of the United States will allow users to view state-level cost estimates for the three categories described above: hospitalization with complexities, general hospitalization and non-hospitalization. Users can browse and compare the median and average charge amounts and estimated allowed amounts for the bundled services by state. This tool will be released as a public service for stakeholders in order to provide valuable insights into healthcare spending.
FAIR Health President Robin Gelburd stated: “FAIR Health strives to make its data relevant and actionable, in this case with up-to-date information on the total costs of care for patients diagnosed with COVID-19. We are excited to soon share a more detailed version of this information as a free resource on our website in the hope that it will be useful to the public as the pandemic further evolves.”
For more information on the FH Total Treatment Cost COVID-19 benchmarks, contact FAIR Health by email at info@fairhealth.org.
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