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

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dc.contributor.authorMouslim, Morgane
dc.contributor.authorSingh, Simone
dc.contributor.authorHenderson, Morgan
dc.date.accessioned2026-02-03T18:15:28Z
dc.date.issued2026-01-14
dc.description.abstractSelf-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.
dc.description.sponsorshipThis work was supported, in part, by funding from the University of Maryland, Baltimore County.
dc.description.urihttps://www.ajmc.com/view/trends-in-hospital-pricing-for-vulnerable-emergency-department-users-2021-2023
dc.format.extent6 pages
dc.genrejournal articles
dc.identifierdoi:10.13016/m25vxm-dbb2
dc.identifier.citationMouslim, 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
dc.identifier.urihttps://doi.org/10.37765/ajmc.2025.89836
dc.identifier.urihttp://hdl.handle.net/11603/41752
dc.language.isoen
dc.publisherAJMC
dc.relation.isAvailableAtThe University of Maryland, Baltimore County (UMBC)
dc.relation.ispartofUMBC Staff Collection
dc.relation.ispartofA. All Hilltop Institute (UMBC) Works
dc.relation.ispartofUMBC Economics Department
dc.relation.ispartofUMBC Faculty Collection
dc.rightsThis item is likely protected under Title 17 of the U.S. Copyright Law. Unless on a Creative Commons license, for uses protected by Copyright Law, contact the copyright holder or the author.
dc.titleTrends in Hospital Pricing for Vulnerable Emergency Department Users, 2021-2023
dc.typeText
dcterms.creatorhttps://orcid.org/0000-0002-6999-7588
dcterms.creatorhttps://orcid.org/0000-0002-0869-5738

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