COVID-19 Hospitalizations for Unvaccinated Cost US Billions

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Preventable hospitalizations of patients unvaccinated against SARS-CoV-2 infection from June through August 2021 have cost an estimated $5 billion according to a joint study published by the Peterson Center on Healthcare and the Kaiser Family Foundation.

The hospitalizations are of course traumatic for patients and for their loved ones and the clinicians who care for them. In addition, study authors point out, US taxpayers, whether through publicly funded health plans or through increased rates of private insurance, are ultimately paying for the avoidable care.

Despite the availability of safe and effective COVID-19 vaccines, US vaccination rates have lagged, particularly in some southern and western states and among younger people. As of early September 2021, 25% of adults over the age of 18 years in the US remain unvaccinated for COVID-19. As a result of the drop off in vaccinations and the rapid spread of the more infectious delta variant, COVID-19 cases, hospitalizations, and deaths are, once again, climbing.

The surge in COVID-19 hospitalizations also is putting financial strain on payers. As a result, insurers are beginning to reinstate cost-sharing for COVID-19 treatment, though patients still only pay a small share of the total costs. The study estimates that the average hospitalization for COVID-19 costs approximately $20,000, though the costs for those requiring a ventilator are much higher.

The study’s analysis of HHS and CDC data indicates there were 32 000 preventable COVID-19 hospitalizations in June, 68 000 in July, and another 187 000 among unvaccinated adults in the US in August—a total of 287 000 across the 3 months.

If each of these preventable hospitalizations cost roughly $20 000, on average, that would mean these largely avoidable hospitalizations have already cost more than $5 billion since the beginning of June.

Real cost probably higher

The study authors say this figure is likely an understatement of the cost burden from preventable treatment of COVID-19 among unvaccinated adults, because it does not include the cost of outpatient treatment, which is likely substantial. They cite a Medicare study that found patients with COVID-related admissions had multiple outpatient visits (3.2 on average) that cost approximately $164 each (and this is only for those COVID-19 patients who were hospitalized at one point).

An analysis of the privately insured found COVID-19 outpatient treatment costs can average $500-$1,000 per patient. There is also reason to believe that average costs for COVID-19 hospitalizations may be even higher than $20 000 based on other studies of privately insured patients and Medicare recipients. One study that has yet to be peer reviewed found that while the median hospitalization costs private payers $25 339, the mean cost was $42 200. Similarly, in their justification for charging higher medical insurance premiums to unvaccinated employees, Delta Airlines said their average hospitalization cost was $50 000 (though it is unclear if this is the median or mean cost).

Additionally, although breakthrough infections and hospitalizations are rare, unvaccinated people are also more likely to spread the virus to those who have taken measures to protect themselves and others, and those costs are not included in the estimate.