PolitiFact VA: What's the average cost of a COVID-19 hospital stay?
To encourage people to get vaccinated against COVID-19, Rep. Pramila Jayapal, D-Wash., posted a comparison between the cost of a hospital stay and the vaccine.
"The average hospital stay for a case of COVID-19 costs about $17,064. The vaccine is free," said Jayapal in her Aug. 30 Instagram post.
It’s true that all three COVID-19 vaccines available in the U.S. are free to recipients. We wanted to know if Jayapal was correct about the average cost for a hospital stay for COVID-19 patients.
Health policy and industry experts said the $17,064 figure sounds about right, based on available data. But they also noted that figuring out an "average" cost for a hospital stay is tricky due to varying factors among patients.
The cost of COVID-19 care can vary widely depending on someone’s age, location, length of stay at the hospital, the hospital where they receive care, severity of illness and comorbidities. Whether someone has no insurance, commercial health insurance, Medicaid or Medicare also plays a role.
"Pinning down an average is hard because for everyone who ended up on a ventilator for weeks, costing millions, there are also people who are in and out of (the) hospital in a day or two once they stabilize," said Niall Brennan, president and CEO of the Health Care Cost Institute, a nonprofit that compiles claims data and offers research on health care costs and utilization.
As backup for Jayapal’s claim, her office sent us an Aug. 26 report from ABC Action News in Tampa. The report said, "No set amount has been found to be a solid average cost. But the numbers hover between $15-25,000 or more."
The news station cited FAIR Health, a nonprofit focused on health costs and health insurance transparency, as a source. FAIR Health analyzed national data from January to May 2020, near the start and first peak of the pandemic, to assess the costs of hospitalization for a COVID-19 patient.
FAIR Health highlighted the median — the middle point — for two different measures of cost:
the charge amount, which is the amount charged to a patient who is uninsured or obtaining an out-of-network service;
and the allowed amount, which is the total fee negotiated between an insurance plan and a provider for an in-network service. The allowed amount includes both the insurer’s and the member’s share of the total fee.
The median charge amount for a COVID-19 hospitalization ranged from $34,662 for patients ages 23 to 30, to $45,683 for people ages 51 to 60, according to FAIR Health.
The median estimated allowed amounts ranged from $17,094 for people over 70 to $24,012 for people ages 51 to 60.
Jayapal used the lowest number as an example of the cost of a hospitalization due to COVID-19, her spokesperson said.
What other sources show
The FAIR Health estimates for the median hospitalization cost are in line with what we found from other sources.
An Aug. 20 brief about unvaccinated COVID-19 hospitalizations from the Peterson Center on Healthcare and Kaiser Family Foundation said various sources suggest an average hospitalization cost of around $20,000.
The brief pointed to estimates from the Centers for Medicare and Medicaid Services, which said that the average Medicare fee-for-service COVID-19 hospitalization cost was $24,033. (CMS said its data was preliminary.)
The Peterson-KFF report said that another study of Medicare fee-for-service enrollees pegged the average cost at $21,752. According to that study, the mean cost was higher if the patient died in the hospital ($32,015) and was highest if the patient needed ventilator support ($49,441). Researchers also said there were racial and ethnic disparities in costs related to COVID-19.
"Racial and ethnic minority patients incurred higher medical costs than non-Hispanic white patients, and non-Hispanic Black and Hispanic patients accounted for disproportionately high numbers of hospitalizations requiring ventilator support and inpatient deaths," the study said.
The American Hospital Association referred us to the Peterson-KFF August brief. "It’s important to note that these reflect averages, and that there is significant variation — for example, some hospitalizations were as much as $80,000 for patients who had prolonged (intensive care unit) stays," said Thomas Jordan, a spokesperson for the trade group.
Exactly how much a person will end up paying out-of-pocket for a hospitalization also depends on multiple factors. For those with health insurance, that can depend on the type of plan they have.
Early in the pandemic, commercial insurers waived cost sharing for COVID-19 treatment, so those individuals might not pay any of the cost, said Ellen Meara, a professor of health economics and policy at the Harvard T.H. Chan School of Public Health. However, people with high deductibles in their private insurance plan, and Medicare-insured individuals can face high out-of-pocket costs — often in the thousands of dollars — due to cost sharing, she said.
Delta Air Lines CEO Ed Bastian said that unvaccinated employees enrolled in Delta’s account-based healthcare plan will be subject to a $200 monthly surcharge beginning Nov. 1, "to address the financial risk the decision to not vaccinate is creating for our company." He said that the average employee’s hospital stay for COVID-19 has cost Delta $50,000 per person.
Jayapal said, "The average hospital stay for a case of COVID-19 costs about $17,064. The vaccine is free."
It’s difficult to determine an average cost for a hospital stay for COVID-19. Many individual factors can cause estimates to swing widely.
But Jayapal’s figure is in line with several credible estimates, and to her bigger point, the vaccine is much cheaper.
We rate her statement Mostly True.