Trends in Hospital Pricing for Vulnerable Emergency Department Users, 2021-2023

Links to Files

https://www.ajmc.com/view/trends-in-hospital-pricing-for-vulnerable-emergency-department-users-2021-2023

Permanent Link

https://doi.org/10.37765/ajmc.2025.89836
 http://hdl.handle.net/11603/41752

Collections

UMBC Staff Collection
A. All Hilltop Institute (UMBC) Works
UMBC Economics Department
UMBC Faculty Collection

Author/Creator

Author/Creator ORCID

https://orcid.org/0000-0002-6999-7588
 https://orcid.org/0000-0002-0869-5738

Date

2026-01-14

Type of Work

journal articles
Text

Department

Program

Citation of Original Publication

Mouslim, Morgane C., Simone Singh, and Morgan A. Henderson. “Trends in Hospital Pricing for Vulnerable Emergency Department Users, 2021-2023 | AJMC.” The American Journal of Managed Care 31, no. 12 (2026): 775–80. https://doi.org/10.37765/ajmc.2025.89836

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Subjects

Abstract

Self-pay emergency department prices rose significantly from 2021 to 2023, especially at for-profit and system-affiliated hospitals, highlighting growing affordability challenges for uninsured and underinsured patients. Objective: To assess the correlates of changes in emergency department (ED) prices for self-pay patients from 2021 to 2023. Study Design: Retrospective longitudinal analysis of self-pay prices for ED facility fees (Current Procedural Terminology [CPT] codes 99283-99285) from 2021 to 2023, using multivariate weighted linear regression to examine the relationship between hospital- and area-level characteristics and trends in self-pay prices and correcting for selective noncompliance with price transparency reporting regulations. Methods: We created a unique longitudinal database of self-pay rates for CPT codes 99283-99285 using national hospital price transparency data from September 29, 2021, and September 29, 2023. Hospital- and area-level characteristics were derived from the 2021 quarter 2 CMS Provider of Services File, the Agency for Healthcare Research and Quality’s 2021 Compendium of US Health Systems, and the 2021 American Community Survey. Results: From 2021 to 2023, self-pay prices increased by a mean of $98.69, $392.85, and $642.74 for CPT codes 99283, 99284, and 99285, respectively. Price increases were notably higher at for-profit hospitals compared with nonprofits, and system affiliation and serving a community with higher levels of uninsured Hispanic/Latino individuals were associated with greater relative price increases for CPT codes 99284 and 99285. Conclusions: Self-pay patients face growing affordability issues in ED access. For-profit and system-affiliated hospitals saw the largest increases. With Medicaid enrollment declines stemming from the end of continuous coverage requirements, which started in mid-2023, the self-pay population may rise, highlighting the need to understand their financial risk exposure.