Texas, New Mexico, New York, California and Kansas had the highest prevalence of out-of-network emergency room billing in 2017 for people with large employer health plans, according to a recent study from the Kaiser Family Foundation.
Prevalence of out-of-network billing in emergency settings was lowest in Minnesota, South Dakota, Nebraska, Alabama and Mississippi.
To determine the incidence of surprise medical bills, researchers examined large employer claims data from IBM’s MarketScan Research Database, representing claims and encounters for nearly 19 million people.
Several states had insufficient data, including Oregon, Idaho, Louisiana and South Carolina.
Here is the share of ER visits with at least one out-of-network charge in 2017, for 40 states, among people with large employer plans. They are listed from highest to lowest.
1. Texas – 38 percent
2. New Mexico – 29 percent
3. New York – 28 percent
4. California – 26 percent
5. Kansas – 24 percent
6. New Jersey – 24 percent
7. Florida – 22 percent
8. Oklahoma – 20 percent
9. Tennessee – 20 percent
10. Nevada – 18 percent
11. Ohio – 18 percent
12. Maryland – 18 percent
13. New Hampshire – 17 percent
14. Rhode Island – 16 percent
15. Arizona – 16 percent
16. Utah – 16 percent
17. Colorado – 15 percent
18. Washington – 14 percent
19. Massachusetts – 14 percent
20. Georgia – 13 percent
21. Arkansas – 12 percent
22. Virginia – 12 percent
23. Illinois – 12 percent
24. Pennsylvania – 12 percent
25. Wisconsin – 12 percent
26. North Carolina – 11 percent
27. West Virginia – 10 percent
28. Connecticut – 10 percent
29. Michigan – 9 percent
30. Missouri – 9 percent
31. Indiana – 8 percent
32. Montana – 8 percent
33. Iowa – 8 percent
34. Kentucky – 8 percent
35. Maine – 7 percent
36. Mississippi – 6 percent
37. South Dakota – 4 percent
38. Alabama – 4 percent
39. Nebraska – 4 percent
40. Minnesota – 3 percent