Kaiser Analysis Examines Out-of-Network Claims in Large Employer Health Plans

A new analysis from the Kaiser Family Foundation looks at inpatient admission and outpatient services to examine how patients are subject to higher cost-sharing and possible additional bills from out-of-network providers. The analysis states, “nearly one in five inpatient admissions includes a claim from an out-of-network provider” which typically include visits to emergency rooms, mental health facilities or substance abuse admissions. Overall, about 18% of inpatient admissions include at least one claim from a provider who is out of network, including when enrollees use in-network facilities for care.