FAIR Health releases COVID cost analysis

A new report from FAIR Health outlines costs associated with COVID-19 treatment, and the allowable amounts as well as patient populations. 

In a state by state analysis of private health care claims from April 2020 to August 2021, New Jersey was the state with the highest average allowed amount for complex hospitalizations for COVID, while Maryland had the lowest. In New Jersey, the average cost was $128,650, and in Maryland it was $49,127. 

 

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Complex COVID hospitalizations are ones requiring ventilation and can include admission to an ICU. Noncomplex hospitalizations in comparison do not require this level of specialized care. 

The state with the highest average allowed amount for noncomplex cases was Alaska at $44,239 per patient, and the state with the highest average allowed amount for outpatient treatment was Nevada with $1,538. Maryland had the lowest average allowed amounts for noncomplex hospitalizations at $12,531, and for outpatient treatment at $580. 

Other findings from the report show that of COVID patients who required a complex inpatient stay, 48.4% had five or more comorbidities, and 20.6% had no comorbidities. To put this into perspective, nearly half of all people diagnosed with COVID had no comorbidities, and patients with five or more comorbidities were roughly 14% of all the total number. 

In COVID patients with a complex hospitalization, the most common comorbidity was hyperlipidemia and/or hypertension, accounting for nearly 15% of cases. In noncomplex hospitalizations, the most common comorbidity were chronic breathing issues at 6.5%. 

The largest percentage of complex hospitalizations occurred in people aged 70 and older, accounting for 17.2% of total instances. Altogether, nearly 33% of patients 70 and older had an inpatient stay for a COVID diagnosis. 

In Washington, the average charge for complex inpatient treatment was $334,224, and the median charge was $254,390. At the same time, the estimated allowed amount was $108,068 and the median was $82,088. 

For noncomplex inpatient treatment, the average charge was $80,336, while the median was $65,187. At the same time, the estimated allowed amount was far lower, with an average of $33,559, and a median of $26,960. 

For outpatient treatment, the average charge was $2,258, with a similar median charge. The estimated allowed and median amounts were roughly $950 each.