Unvaccinated hospitalization costs reach $13.8 billion, study says

KELOLAND.com Original

SIOUX FALLS, S.D. (KELO) — Unvaccinated patients hospitalization costs totaled $13.8 billion in preventable costs from June through November 2021, according to an analysis from the Kaiser Family Foundation (KFF).

The KFF study estimates there was a total of 690,000 vaccine-preventable COVID-19 hospitalizations during that six months.

The hospitalization cost will vary depending on insurance, hospital stay and degree of severity of illness but the average costs, based on studies, was about $20,000, the KFF analysis said. That’s the figure used to calculate the cost of unvaccinated hospitalized individuals.

The KFF analysis said the typical out-of-pocket cost to a patient with private insurance hospitalized with COVID-19 pneumonia of about $1,300.

Between June and August, 98.6% of people hospitalized with a COVID-19 diagnosis were unvaccinated, according to the KFF.

The trend of unvaccinated individuals making up the largest share of hospitalized COVID-19 patients continues.

On Dec. 22, Sanford Health reported that 92% of the patients hospitalized with COVID-19 were unvaccinated. On Jan. 4, 176 of the 201 hospitalized were unvaccinated.

While the majority of COVID-19 hospitalizations are still in unvaccinated individuals, there have been breakthrough hospitalizations of individuals who have been fully vaccinated.

Most of those have been people 65 and older so far.

Sixty-nine percent of breakthrough COVID-19 hospitalizations have occurred among people ages 65 and older, who are more likely than younger age groups to have gotten vaccinated, KFF said on Dec. 15. Another 21% of breakthrough hospitalizations have occurred among people ages 50-64, while 10% are among younger adults.

Whether it’s a breakthrough COVID-19 hospitalization or a hospitalized unvaccinated person 65 and older, there’s a good chance the individual may be on Medicare, or if in a nursing home, on Medicaid.

The Centers for Medicare and Medicaid Services said on April 16 that the average Medicare fee for service COVID-19 hospitalization cost $24,033. The cost was an analysis of hospitalizations from Jan. 1, 2020, to March 20, 2021. During that period 54% of the Medicare patients were hospitalized one to seven days.

Nearly 181,000 residents were enrolled in Medicare in South Dakota as of November 2020. The South Dakota Department of Social Services said in an October 2020 report that more than 54% of all residents of nursing homes were on Medicaid.

If a hospitalized individual has insurance or Medicare or Medicaid, there will still be out-of-pocket costs to pay.

The KFF analysis said the typical out-of-pocket cost to a patient with private insurance hospitalized with COVID-19 pneumonia of about $1,300.

Since the start of 2021, many insurers have lifted the waiver of some hospitalization costs such as co-pays and deductibles, which mean out-of-pocket costs could increase for individuals.

A study from the University of Michigan said in October that “based on data from actual patients hospitalized for COVID-19 last year, the study suggests the lack of waivers could mean bills of about $3,800 for people with job-related or self-purchased private insurance, and $1,500 for people with Medicare Advantage plans.”

A study from FAIR HEALTH said in April 2020 estimated the average charge per COVID-19 hospitalized patient at $73,300. That charge is the estimated cost for a patient with no health insurance.

What happens when a hospitalized individual cannot afford to pay for the out-of-pocket expense?

Some of it may end up as uncompensated care for hospitals.

Since 2000, hospitals of all types have provided more than $702 billion in uncompensated care to their patients, according to the American Hospital Association. The uncompensated care totaled $41.61 million in 2019.

The KFF said in June that one quarter of all unvaccinated individuals do not have health insurance.

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