Table 1. Prevalence and Magnitude of Potential Surprise Bills According to the Occurrence of Cesarean Delivery and Neonatal Intensive Care.
| Outcome | All deliveries (N = 95 384)a | ≥1 Cesarean delivery claim (n = 32 203)b | No cesarean delivery claims (n = 63 181)b | Difference between medians (95% CI)c |
|---|---|---|---|---|
| Deliveries | ||||
| No potential surprise bills, No. (%) | 83 193 (87.2) | 25 609 (79.5) | 57 854 (91.1) | NA |
| ≥1 Potential surprise bill, No. (%) | 12 191 (12.8) | 6594 (20.5) | 5597 (8.9) | NA |
| Median estimated liability for potential surprise bills (25th-75th percentile), $d | 1356 (180-4595) | 1825 (272-5624) | 900 (124-3642) | 925 (760-1091) |
| Newborn hospitalizations | All newborn hospitalizations (n = 96 881) a | ≥1 Neonatal intensive care claim (n = 5970) b | No neonatal intensive care claims (n = 90 991) b | Difference between medians (95% CI) c |
| No potential surprise bills, episodes, No. (%) | 87 854 (90.7) | 5044 (84.5) | 82 810 (91.1) | NA |
| ≥1 Potential surprise bill, episodes, No. (%) | 9027 (9.3) | 926 (15.5) | 8101 (8.9) | NA |
| Median estimated liability for potential surprise bills (25th-75th percentile), $d | 262 (123-766) | 1282 (217-10 472) | 262 (123-622) | 1031 (971-1091) |
Abbreviation: NA, not applicable.
a
The 95 384 families were linked to 96 881 newborn hospitalizations. Among the 95 384 families, 93 910 had deliveries linked to 1 newborn hospitalization, 1451 had deliveries linked to 2 newborn hospitalizations, and 23 had deliveries linked to 3 newborn hospitalizations. For the latter 2 groups, the multiple newborn hospitalizations were for unique newborns.
b
See eAppendix 2 in the Supplement for codes used to define these claims.
c
May not equal the difference between columns 2 and 3 because of rounding. We calculated confidence intervals using quantile regression.
d
Equals out-of-network charge minus standardized cost, an estimate of the insurer’s national average in-network reimbursement.