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Members of clinical staff complete paperwork at a hospital. Photo: Oli Scarff/AFP via Getty Images

A new Kaiser Family Foundation brief finds that, among people with employer-based coverage, almost one in five patients admitted to the hospital end up getting a bill from an out-of-network provider.

Why it matters: Patients have to pay more out of their own pockets for out-of-network care.

  • As a lot of excellent recent reporting on emergency room billing has shown, it can be almost impossible to avoid out-of-network bills even when you take pains to ensure you're going to an in-network hospital.

Balance billing — the practice of providers billing patients for the difference between their charges and insurance payments — is often responsible for these situations.

  • The Affordable Care Act required private plans to limit annual cost-sharing, but these generally only apply to in-network service charges.
  • Patients with emergency room claims and psychological/substance abuse claims are more at risk of receiving an out-of-network provider claim, per Kaiser.

By the numbers: For inpatient admissions, those who use in-network facilities still receive a claim from an out-of-network provider 15.4% of the time.

Go deeper

Bryan Walsh, author of Future
31 mins ago - Health

Falling sperm counts could threaten the human race

Illustration: Sarah Grillo/Axios

A new book makes the case that sperm counts have been falling for decades — and a major reason is chemicals in the environment that disrupt the body's hormonal system.

Why it matters: The ability to reproduce is fundamental to the viable future of any living thing. If certain chemicals are damaging our fertility over the long term, human beings could end up as an endangered species.

2 hours ago - Health

Black churches become vaccine hubs

A woman arrives at a COVID-19 vaccination clinic outside the Pennsylvania Avenue Baptist Church in southeast D.C. Photo: Jacquelyn Martin/AP

Black pastors have a new job on their plates during COVID-19: encouraging skeptical congregants to get vaccinated.

Why it matters: “There’s distrust in our community. We can’t ignore that,” Rev. James Coleman of D.C.'s All Nations Baptist told AP.

Biden names USPS board of governors nominees, as Democrats put pressure on DeJoy

United States Postal Service Postmaster General Louis DeJoy at a Feb. 24 committee hearing. Photo: Graeme Jennings/pool/AFP via Getty Images

President Biden on Wednesday nominated a former postal union lawyer, a vote-by-mail advocate, and a former deputy postmaster general to sit on the Postal Services' Board of Governors.

Why it matters: The nominations, which require Senate confirmation, come as some Democrats call for Postmaster General Louis DeJoy's ouster and others push for Biden to nominate board members to name a new postmaster general.

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