Hilltop Policy Analyst Morgane Mouslim, DVM, and Director of Analytics and Research Morgan Henderson, PhD, as well as Associate Professor Simone Singh of the University of Michigan, are co-authors of a recently released article in the American Journal of Managed Care titled Trends in Hospital Pricing for Vulnerable Emergency Department Users, 2021-2023. The authors present the results of their study that analyzes changes in emergency department (ED) facility fees for self-pay patients and highlights growing affordability challenges for uninsured and underinsured individuals. Drawing on hospital price transparency data from 926 hospitals reporting self-pay ED facility fees in both 2021 and 2023, the study identified significant inflation-adjusted price increases across all visit severity levels, with the steepest growth observed at for-profit and system-affiliated hospitals and in communities with higher proportions of uninsured Hispanic/Latino residents.
Although self-pay patients represent a minority of ED users, they accounted for 9.1 million visits in 2021, and rising prices increase risk of medical debt, delayed care, and exacerbated disparities in health outcomes. Moreover, the recent passage of H.R. 1 means that millions are expected to lose coverage through administrative and eligibility-related disenrollments. Thus, the number of individuals who must self-pay for emergency care will likely increase. Given that self-pay ED prices remain largely unregulated nationwide, the study underscores the need for attention to the affordability of ED care for self-pay patients.
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