1 in 3 patients postpone healthcare due to existing medical debt, says TransUnion

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Dive brief:

  • Thirty-five percent of patients with unpaid medical bills reported that the debt dissuaded them from seeking healthcare services over the past year, according to a new survey of consumer billing experiences from TransUnion Healthcare.
  • The credit bureau’s health data analysis unit also reported a 55% increase in financial aid transactions from September 2020 to September 2021. These transactions, which number in the millions, are being conducted by TransUnion to assess a patient’s ability to pay and determine charitable options.
  • The increase in financial aid transactions likely stems from the economic downturn caused by the coronavirus pandemic, the company said. The analysis was released at the Healthcare Financial Management Association’s annual conference underway virtually and in Minneapolis.

Dive overview:

The pandemic appears to be changing the landscape of healthcare once again, as patients postpone doctor visits to avoid contracting the virus. A report released this month by consultants Kaufman Hall showed that hospital margins fell more than 18% in September from August, as patient volumes fell in key categories such as emergency room visits, operating room minutes and outpatient income.

Previously, nearly six in 10 respondents to a TransUnion survey last September said they had postponed non-COVID-related medical care over the previous six months, while nearly half said the economy had at least one impact on the way they approached medical care.

The latest data from TransUnion suggests that financial concerns are also factored into current patient decisions to delay seeking care. It echoes similar research released in June by payment technology company Patientco, which also found that one in three patients avoid seeking treatment. due to cost barriers.

“It’s scary and sad to know that people are giving up their physical and mental health for fear of ruining their financial health with medical treatment,” said Jonathan Wiik, director of healthcare strategy for TransUnion Healthcare.

Up to 3 million people may have lost employer-sponsored health insurance due to COVID-19 in the early months of the pandemic, according to Kaiser Family Foundation analysis. At the same time, Medicaid enrollments increased as people lost their jobs and insurance, while others gained private coverage by enrolling as dependents on a member’s plan. of the family.

Amid the coverage disruptions, many people have delayed getting treatment, Wiik said.

The upheaval caused by the pandemic comes against a backdrop of rising health spending for workers, with average family premiums on the rise 4% to $ 21,342 in 2020, according to a KFF survey of employer health benefits. Workers contributed an average of $ 5,588 of the total amount, with employers covering the remainder.

Hospitals were already doing more financial aid transactions before COVID-19 hit. The pandemic has accelerated this trend, reflecting increased financial pressure on healthcare systems and patients struggling with the burden of higher costs, according to TransUnion.

Transactions increased 49% from September 2019 to September 2020 and 60% the year before. “We’ve seen this increase quite dramatically over the past three years,” Wiiks said.

While the economic downturn caused by the pandemic likely increased demand for financial aid transactions, other factors such as predatory hospital billing practices also played a role, Wiiks said.

Last year, TransUnion found that 70% of patients said knowing the cost before having a medical procedure helped them budget for payments, while 65% said they would make at least a partial payment if one. prior estimate was provided.

Hospital pricing transparency rules now in place could make it easier to find this information, but facilities have so far been mostly non-compliant. Last week, CMS said it was raising fees for hospitals that don’t publish their managers online to as much as $ 2 million per year for large facilities.


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