October 4, 2021 – There is a huge variance in the cost for similar Covid-19 treatments, even within the same hospital, according to a Wall Street Journal analysis. The analysis found that half of the rates for intensive treatment requiring a ventilator were below $90,000, but treatment could topped out above $200,000 in some cases.
The WSJ analysis found that rates for treating respiratory conditions like those common among Covid-19 patients had a range from less than $11,000 to more than $43,000.
But for more severe cases, the prices could be far higher. For instance, at NewYork-Presbyterian Weill Cornell Medical Center (New York, NY), the cost for a severe-respiratory patient could change by as much as $40,000 depending on the insurer.
The same patient at that hospital would have the following rates per insurer:
- Aetna – $55,182
- UnitedHealthcare – $64,326,
- Empire Blue Cross Blue Shield – $94,357
The range of prices shows how similar hospital services can generate widely disparate bills – for virtually all services the hospital provides. The prices often reflect the leverage that an insurer has to wrangle discounts, as well as the hospital’s market power to drive up its rates, the Wall Street Journal noted.
A spokeswoman for NewYork-Presbyterian said it negotiates each insurance contract individually and the cost to patients varies significantly depending on the care they receive, their coverage and their eligibility for financial assistance.
Throughout much of the pandemic, insurers waived out-of-pocket charges for Covid-19 treatment, so the variable costs didn’t directly affect patients’ pocketbooks. Now, patients are increasingly facing charges such as deductibles or coinsurance, which can depend on rates that hospitals and insurers negotiated, according to the Kaiser Family Foundation.
A federal fund that can pick up the cost of Covid-19 treatment is focused on the uninsured. As a result, many patients with private coverage may actually pay more out of their pockets than those with no health plan at all.
Under a Trump-era federal rule that went into effect this year, pricing data became public. The Wall Street Journal analyzed this data for hundreds of hospitals, to understand what Covid-19 treatment costs. The analysis focused on private insurance, the kind offered by employers or purchased individually, not government-backed plans under Medicare or Medicaid.