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Instant Insights / Health Care Cost Transparency, Surprise Billing, and the Employee Benefits Industry

Typically, patients, and their employers, don't know the cost of health care or are given inaccurate estimates. Then come the surprise medical bills and costly overruns of employers' benefits budgets. Here's a look at the health care cost transparency problem and how people are trying to solve it.

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The highest percentage of specialty surprise claims came from anesthesiology, at 16 percent. Primary care represented 13 percent, and emergency medicine 11 percent. (Photo: Shutterstock)

A new study finds that one in seven patients are hit with a surprise medical bill—an out-of-network charge for a medical service—even though they were admitted to an in-network hospital.

The new analysis, from the Health Care Cost Institute (HCCI), looked at 620,000 patients across 37 states and the District of Columbia in 2016. “Overall, we found that 14.5 percent of these admissions had at least one associated out-of-network professional claim; that is, roughly 1 in 7 patients received a surprise bill despite obtaining care at an in-network hospital,” the report said.

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