Big Out of Pocket Costs Impact Ability to Pay
Check out this article below from the Wall Street Journal. The impact that rising out of pocket medical costs have on the middle class, as well as the poor, is troubling. And, it is not only troubling from a sociological point of view--but to your office.
Few practices have personnel who can meet with patients caught in a financial bind and find solutions to their billing woes.
What do we suggest?
- Make sure you have one person who has a private place to discuss payment issues.
- Have counseling sessions before the bill grows continually larger.
- Know what the guidelines are for ”below the poverty line”.
- Tap into the financial counseling resources in your community so you can make good referrals.
- Know what sliding scales the hospital and community mental health center have for people with low income.
- Consider a reduced fee schedule for PROVEN and documented ”hardship cases”. Charging these patients your highest fee hardly makes sense.
- Don’t let you’re A/R grow because of this issue!
- Make sure you pre-register patients before they come in so you know who will likely need prospective counseling.
Rising Health-Care Costs Hit Home
By MARY KISSEL
Staff Reporter of THE WALL STREET JOURNAL
June 30, 2004; Page D2 (See Corrections & Amplifications item below.)
WASHINGTON -- One in seven American families has problems paying medical bills, forcing trade-offs between medical, food and housing expenses, according to a new study.
The report by the Center for Studying Health System Change, a Washington think tank, said that though uninsured families have the biggest problems affording health care, insured families have difficulty paying their medical bills, especially since rapidly rising health-insurance costs are often shifted to consumers in the form of higher deductibles, co-payments and co-insurance.
According to the study, 68% of families with medical-bill problems have insurance. ”Being uninsured or having low income is terrible, but being insured isn’t a guarantee of success”, said Bob Crittenden, chairman of the Working for Health Coalition, based in Seattle.
Insured or not, poor families still shoulder some of the heaviest medical-bill burdens, according to the study. Of the approximately 20 million American families that have trouble paying medical bills, nearly 20% had incomes below the poverty line last year, while nearly 22% were classified as ”low income”. The HSC defined the poverty level as $36,800 for a family of four in 2003.
The study, called the 2003 Community Tracking Study Household Survey, relied on responses from 25,419 families, or 46,587 individuals. The telephone survey had a 57% response rate.
Rising out-of-pocket costs were positively correlated with inability to pay, with 35% of families reporting problems paying $2,000 or more in annual medical bills. But even modest out-of-pocket medical expenses can hit low-income families hard, warned Peter Cunningham, one of the report's authors. About 20% of low-income families reported difficulties paying medical bills, compared with 7.4% of families with incomes fivefold higher than the poverty level.
Patients with chronic illnesses also drive up healthcare costs, Mr. Cunningham said. About 18% of surveyed families that had one or more members with chronic diseases had trouble paying their medical bills. Chronic conditions, which include diabetes, cardiac disease and respiratory illnesses, make up a major portion of spending on health care.
The report comes at a time when consumers have taken on high levels of debt, driven by low interest rates, easy credit terms and increased home ownership. Roger Whelan, a resident scholar at the American Bankruptcy Institute in Alexandria, Va., said medical bills are a leading driver of personal bankruptcies.
But big medical bills don’t only inflict a financial burden -- they affect patient behavior, too. According to the report, about a quarter of families with big medical tabs shied away from seeking care last year, and nearly a third shunned prescription drugs.
That is troubling, said Michele Heisler, a researcher at the Veterans Affairs Ann Arbor Healthcare System in Ann Arbor, Mich., and author of a recent National Institutes of Health study that examined how medication cutbacks for patients with chronic illnesses can inflict severe health damage.
”There are a lot of effective medications out there, which makes the problem of access to medicines a concern,” Dr. Heisler said.
Corrections & Amplifications:
The HSC defined the poverty level as income of $18,400 for a family of four in 2003, not $36,800.
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