Evidence map›Paper›PMID 41522177›Full record

ArticleTracheostomy (Warrenville, Ill.)2025

Out-of-Pocket Costs and Potential Surprise Bills for Tracheostomy in Commercially Insured Patients.

Nicholas R Lenze, Jasdeep S Kler, Chamila D Perera, Karan R Chhabra, David Goldenberg, Vinciya Pandian, Michael J Brenner

Abstract read
In one paragraph

Article in Tracheostomy (Warrenville, Ill.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Nicholas R LenzeDepartment of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI, USA.
Jasdeep S KlerDepartment of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI, USA.ORCID 0000-0003-1259-0055
Chamila D PereraDepartment of Biostatistics, University of Michigan, Ann Arbor, MI, USA.
Karan R ChhabraDepartment of Surgery, New York University Grossman School of Medicine, New York, New York, USA.
David GoldenbergDepartment of Otolaryngology-Head and Neck Surgery, Pennsylvania State University College of Medicine, Hershey, PA.
Vinciya PandianDepartment of Otolaryngology-Head and Neck Surgery, Pennsylvania State University College of Medicine, Hershey, PA.ORCID 0000-0002-2260-1080
Michael J BrennerDepartment of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI, USA.ORCID 0000-0003-4926-0957

Funding

Institutional Career DevelopmentKL2TR001446 · NCATS · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI PILLINGER, MICHAEL · 2015 to 2025
$6.7M
Michigan Otolaryngology Research Education (MORE)R25DC020262 · NIDCD · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Gabriel Corfas · 2023 to 2026
$1.1M
NCATS NIH HHS KL2 TR001446NIDCD NIH HHS R25 DC020262
6 · The paper itself

Abstract

Introduction: Tracheostomy involves complex, resource-intensive care. Yet, few data about the procedure-related cost burden for patients and their families are available. Passage of the No Surprises Act has been associated with changes in patient billing for certain healthcare services, but data on tracheostomy have not been investigated. Methods: We conducted a retrospective cohort study using the Merative MarketScan database for commercially insured patients aged 18-64 who underwent tracheostomy from 2014-2022 in the United States. We estimated out-of-pocket (OOP) costs (sum of deductibles, copay, and coinsurance) and potential surprise bills (an out-of-network claim where both the primary surgeon and facility were in-network) within 30 days of surgery. Relationships between OOP costs, potential surprise bills, and patient- and system-level exposures were analyzed. Results: Among 8,950 patients who underwent tracheostomy, the mean (SD) age was 49.3 (12.7) years; most patients were male (61.8%) and had fee-for-service based insurance (79.8%). The mean (SD) total OOP cost attributable to tracheostomy was $1,423 (2,029), and coinsurance accounted for 62.8% of these costs. Potential surprise bills were present in 9.1% of surgical episodes overall and were associated with higher OOP costs (mean (SD) $1909 (2433) vs. $1444 (2021); p<0.001)). High-deductible health plans and fee-for-service based plans were the largest predictors for overall OOP costs (cost ratio 2.66 and 1.84, respectively; p<0.001 for both) and potential surprise bills (odds ratio 2.07 and 2.78, respectively; p<0.001 for both). The incidence of potential surprise bills diminished over the course of the study period. Conclusions: Patients undergoing tracheostomy have significant exposure to OOP costs, predominantly attributable to coinsurance, with potential surprise bills representing an additional source of cost exposure. These findings highlight the need for financial counseling and policy reform to reduce patient cost burdens.

Indexed as

Commercial insuranceCost analysisEconomicsFinancial burdenHealth expendituresHealth insuranceHealth services accessibilityOut-of-pocket costsSurprise BillingTracheostomy

Identifiers

PMID41522177
PMCPMC12782569

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.