How to Avoid Overnight Hospital Stays — and Save a Ton of Money
Outpatient procedures are much cheaper than overnight hospital visits. Here’s what you need to know.
Receiving the bill after an overnight hospital stay can be incredibly anxiety-inducing. The average cost of a three-day hospital stay is about $30,000, according to the U.S. Centers for Medicare & Medicaid Services.
“Hospitals are at the top of the pyramid in terms of the cost of healthcare,” says Cindi Gatton. She’s vice president of Healthcare Advisory at Caribou, a company that helps people navigate the complexities of healthcare.
Because hospitals are open 24/7, they have to make sure staff and services are always available. “This increases their operational costs significantly more than facilities that are open 7 a.m. to 6 p.m., as an ambulatory surgery center might be,” Gatton says. National Nurses United found that U.S. hospitals charge an average of $417 for every $100 they spend in total costs.
Hospital procedures themselves are also expensive. And an overnight stay can really bump up the total cost.
One 2017 study published in the Orthopaedic Journal of Sports Medicine found that people who underwent knee surgery at inpatient facilities spent an average of around $47,000. But those who opted for outpatient (also called “ambulatory”) procedures paid about $26,000. The real kicker: The results were the same in both cases.
Need more convincing? A 2021 study published in Annals of Surgery analyzed inpatient and outpatient outcomes across four types of surgery. Researchers found that the outpatient surgeries actually had lower rates of readmission.
If you can have your procedure performed at an outpatient facility, you can save lots of money and get equal care. Here are a few ways to make sure you get the best rates at an outpatient facility.
Pick an outpatient facility in advance when possible
Emergencies happen, so you can’t plan for every procedure. “Having your appendix removed isn’t necessarily a time that most people are shopping for lower costs,” Gatton says. But certain procedures, such as hip replacements and hernia repairs, are less urgent and can be scheduled in advance. This gives you time to shop for the lowest-priced providers in your area.
Picking an outpatient facility instead of driving to the nearest hospital could save you travel time too. One National Bureau of Economic Research report estimates that people drive past six lower-priced providers on their way to where they get their MRI (magnetic resonance imaging) performed.
Check that your facility is in network
If the facility you choose doesn’t participate with your insurance company, you might get stuck paying out of pocket for the entire procedure. Confirming with the facility and your insurance company can help you avoid steep costs for out-of-network care, Gatton says.
Check that the surgeons and staff are also in network
If a medical facility is in network, surely the surgeons and anesthesiologists who work there are also in network, right?
Not necessarily. A doctor might not participate with your insurance, even if the facility where they work does. Checking this ahead of time can help you avoid any surprises on your bill.
Don’t be afraid to negotiate costs
You can always negotiate costs with an outpatient facility upfront (meaning before you undergo a treatment), Gatton says.
Reach out to the facility’s billing department and find out how much your procedure will cost. Then contact your health insurance company to get an estimate. From there, you’ll have all the information you need to negotiate costs.
Understand how you’ll be billed
As with hospitals, not all outpatient facilities are the same. Gatton recommends shopping around for the best price once you know which elective surgery you’ll need. But you should also understand how you’ll be billed.
This includes knowing the hospital billing codes vs. outpatient center codes. “Some outpatient centers are actually structured financially as part of a hospital,” she says.
Talk to your insurance company and the outpatient facility to make sure you get all your questions answered. And once you get your Explanation of Benefits and bill, carefully look over every charge. Nearly 80% of medical bills contain erroneous charges, according to Becker’s Hospital Review.
Additional sources
Average cost of a three-day U.S. hospital stay: U.S. Centers for Medicare & Medicaid Services. “Protection from high medical costs”
Report on U.S. hospital stays: Agency for Healthcare Research and Quality (2018). “Overview of U.S. Hospital Stays in 2016: Variation by Geographic Region”
Report on rising hospital prices: National Nurses United (2020). “Fleecing Patients: Hospitals Charge Patients More Than Four Times the Cost of Care”
Comparing outpatient and inpatient costs for knee surgery: Orthopaedic Journal of Sports Medicine (2017). “Cost Comparison of Outpatient Versus Inpatient Unicompartmental Knee Arthroplasty”
Comparing outpatient vs. inpatient prices: Annals of Surgery (2021). “Where Is the Value in Ambulatory Versus Inpatient Surgery?”
Price shopping for MRI scans: National Bureau of Economic Research (2018). “Are Health Care Services Shoppable? Evidence from the Consumption of Lower-Limb MRI Scans”
Report on increase in medical billing errors: Becker’s Hospital Review (2016). “Medical billing errors growing, says Medical Billing Advocates of America”