Concussion costs usually passed on to families

By Josh Medore

The NewsOutlet.org

YOUNGSTOWN

Concussions are costly.

Here is the tab you can accumulate:

Emergency room visit: $1,664.

CT scan: $1,462.

MRI: $3,665.

Hospital stay: $34,030.

These numbers, while typical in the Mahoning Valley, may seem far-fetched to some, but consider this: Nearly 1 in 10 people who end up in an emergency room with a sports-related concussion have injuries serious enough to require hospitalization.

Nationwide, that’s an average of 21,839 people a year, according to 16 years of data from the National Electronic Injury Surveillance System, operated by the U.S. Consumer Product Safety Commission.

The average stay is 21/2 days, according to 2011 data from the Agency for Healthcare Research and Quality.

“They always do blood work. That’s automatic,” said Joann Gelonese, who works as a pharmacist at St. Elizabeth Health Center in Boardman. She has two sons, both of whom have had multiple concussions.

“They may consult a neurologist depending on the symptoms. They may do an EEG test, which could even lead into an MRI, but it’s hard to say,” she said.

Insurance may not be enough

The Gelonese family has insurance to pays most of the bills. Those costs eventually are passed on to consumers, however, in the form of higher premiums or cuts in coverage, insurance experts say.

Even when an athlete is released from an emergency room after treatment, many families face high-deductible insurance plans — requiring $2,000 to $3,000 out of pocket before insurance kicks in.

That makes it hard to predict a concussion’s cost.

“For an isolated case, it’s impossible for me to tell you. It may be $200, or it may be $2,000,” said John Doneyko, head athletic trainer at Youngstown State University.

For Gelonese, whose two sons have been playing sports most of their lives, concussions and their repercussions have become part of her life. Her sons, now in college, remain active in sports.

By Gelonese’s count, her sons have had seven concussions between them resulting from playing team sports, mostly football. The most serious happened in a wrestling match when her oldest son was in seventh grade.

An official didn’t stop the match when Gelonese’s son and his opponent moved outside the ring and off the mat. Before the official intervened, Gelonese’s son was dropped on his head on the hard floor.

The result was a concussion and retinal damage caused by swelling. Instead of taking her son to the hospital, she took him to a specialist, who ordered a CT scan. The treatment was costly, but Gelonese’s family insurance covered most of it aside from co-pays and modest deductibles.

For others dealing with concussions — when the number of injuries and visits to doctors and hospitals begins to pile up — the bill can run in the tens of thousands of dollars and seem impossible to pay.

Few opt for extra insurance

At the beginning of each season, Canfield High School’s student athletes receive an insurance form asking if they are satisfied with their current coverage or if they’d like to buy insurance through the school in a Student Accident Coverage policy, said Greg Cooper, Canfield’s athletic director.

“This kind of coverage is what they call excess coverage, meaning that if the parents have other insurance, it has to go through their coverage first and then this picks up” deductibles or co-insurance that aren’t paid, said Kevin McKinstry, an agent at Cornerstone Insurance in East Palestine. His company provides this type of policy to about 40 schools in Mahoning, Columbiana and Trumbull counties, including Austintown Fitch, Canfield, Mineral Ridge and East Palestine.

If the student’s family doesn’t have insurance, the Student Accident Coverage policy can be used as primary insurance.

In 2013-14, Student Accident Coverage policies ranged from $28 to $371 per school year, said McKinstry. Maximum coverage is $25,000.

Many families, though, don’t buy the extra coverage.

“It’s not very common,” McKinstry said. “I would say now, my overall average for school population … would probably be 1 percent or less.”

Uninsured families of student athletes may have other options, however.

Those families at or below the federal poverty line or enrolled in the Disability Assistance Program may be eligible for the Ohio Health Care Assurance Program, which will pay for hospital costs. Families aren’t eligible, however, if they are enrolled in Medicaid.

HCAP covers hospital expenses for those meeting the requirements, but not other medical costs such as physicians or pharmacy services.

“The program provides for the write-off of hospital bills,” according to Human Arc, an eligibility enrollment service based in Cleveland.

High schools are rarely held responsible for paying for the bill.

“Only if somebody had no insurance or there was no one else to pay, then they’d probably come to the school and look to get it from them, but that hasn’t occurred that I’m aware of,” Cooper said.

At the collegiate level, schools usually pay for secondary insurance.

For the 2013-14 fiscal year, YSU’s athletic department has a $124,160 policy that acts as excess coverage. The policy’s price tag is nearly 21/2 times its cost three years ago due to rising medical costs.

The maximum claim on an athletic insurance policy is $90,000. If insurance money runs out, however, the NCAA can provide coverage through its Catastrophic Injury Program, which offers an additional $90,000 in coverage.

Prevention costs add up

For colleges and high schools, the obvious costs — those that can be seen by fans and parents — are for equipment and concussion tests.

The concussion baseline test that YSU uses is the Immediate Post-Concussion Assessment Cognitive Testing system. The ImPACT test can cost from $500 to $1,000 per school each year.

“As soon as an athlete walks through the door — before they’ve competed or practiced or weight-lifted or conditioned — they are required to submit a ton of paperwork,” Doneyko said. “One of them is a physical. There are insurance forms, questionnaires and what-have-you. Then we sit down at the computer and give them the baseline test.”

Several high schools in the Valley, including Canfield, also use the ImPACT test. Denny Kovach, trainer for Canfield, said his school spends about $500 on the system every year.

Overall, Cooper, Kovach and Alvy Armstrong, the equipment manager for YSU, agree that helmets are the most-important factor in preventing concussions in any sport. The cost of helmets is going up, putting a strain on athletic-department budgets.

“A decade ago, you could get a helmet for $100 — you might even have been able to get it for $80,” Armstrong said. “Now, you’ll probably go in the neighborhood of $150 to $170 on the cheap to $325, $350 on the higher end.”

Canfield is switching to the Xenith X2 helmet, which lists for $250 on the company’s website. YSU is also buying the X2, along with the Schutt Vengeance. That helmet lists at $255 on various equipment websites.

“We’re looking into the safety and well-being of 400 student-athletes. Then the next thing is making sure they get a degree,” said Ron Strollo, executive director of intercollegiate athletics at YSU.

“I would hope that we go home every night more comfortable with how we’re taking care of our kids,” he added.

TheNewsOutlet.org is a collaborative effort among the Youngstown State University journalism program, The University of Akron, Cuyahoga Community College and professional media outlets including, WYSU-FM Radio and The Vindicator, The Beacon Journal and Rubber City Radio of Akron.