Hospital stays top $1,200 out-of-pocket even with insurance, U-M study finds

That amount has gone up sharply in recent years, rising more than 37 percent just for straightforward hospital stays for common conditions. The statistics come from the first published analysis of actual out-of-pocket spending by people with private health insurance, most of it provided by employers. The study appears in JAMA Internal Medicine.

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The biggest change in out-of-pocket spending came from two types of insurance plan charges. Deductibles - the amount patients pay for their care before their insurance kicks in - increased 86 percent. Coinsurance - a percentage of hospital costs insurance plans often expect patients to pay - rose 33 percent.

"These results open up the 'black box' of health care and show all the costs of hospitalization that are billed to people with private insurance. For many, these may appear to be 'hidden costs' that they didn't realize they would owe," said first author Emily Adrion, a research fellow with the U-M Center for Healthcare Outcomes and Policy. "It shows that even people with the most comprehensive insurance are paying thousands of dollars, at a time when they need hospital care and may not have time to shop around."

Adrion and colleagues, including senior author Dr. Brahmajee Nallamothu, say that growth in out-of-pocket costs was 6.5 percent a year, compared to 5.1 percent growth in health insurance premiums and 2.9 percent growth in overall health care spending.