- Thirty-five percent of patients with outstanding medical bills said that debt deterred them from seeking healthcare services over the past year, according to a new survey of consumers' billing experiences by TransUnion Healthcare.
- The credit bureau's healthcare data analytics unit also reported seeing a 55% rise in financial assistance transactions from September 2020 to September 2021. Those transactions, which number in the millions, are conducted by TransUnion to assess a patient's ability to pay and determine charity options.
- The rise in financial assistance 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 annual conference underway virtually and in Minneapolis.
The pandemic appears to again be altering the healthcare landscape as patients defer doctor visits to avoid contracting the virus. A report this month from consultants Kaufman Hall showed hospital margins declined more than 18% in September from August as patient volumes fell in key categories such as emergency room visits, operating room minutes and outpatient revenues.
Previously, almost six in 10 respondents to a TransUnion survey last September said they deferred non-COVID-related medical care in the prior six months, while nearly half said the economy had at least some impact on how they approached medical care.
TransUnion's latest data suggests financial concerns are factoring into patients' current decisions to delay seeking care as well. It echoes similar research released in June from payment technology company Patientco, which also found that one in three patients avoided seeking healthcare due to cost barriers.
"It's scary and sad to know people are forgoing their physical and mental health for fear that they'll ruin their financial health with medical treatment," said Jonathan Wiik, principal of healthcare strategy for TransUnion Healthcare.
As many as 3 million people may have lost employer-sponsored health insurance due to COVID-19 in the early months of the pandemic, according to a Kaiser Family Foundation analysis. At the same time, enrollment in Medicaid climbed as people lost their jobs and insurance, while others obtained private coverage by signing up as dependents on a family member's plan.
Amid the disruptions to coverage, many people put off getting care, Wiik said.
The upheaval wrought by the pandemic comes against the backdrop of rising healthcare expenses for workers, with average family premiums up 4% to $21,342 in 2020, according to a KFF employer health benefit survey. Workers contributed $5,588 on average to the total amount, with employers covering the remainder.
Hospitals were already running more financial assistance transactions before COVID-19 struck. The pandemic accelerated that trend, reflecting increased financial pressure on healthcare systems and patients struggling with the burden of higher costs, according to TransUnion.
Transactions rose 49% from September 2019 to September 2020 and 60% in the year before that. "We've seen that increase pretty dramatically over the last three years," Wiiks said.
While the economic downturn brought by the pandemic likely increased demand for financial assistance transactions, other factors like predatory hospital billing practices also played a role, Wiiks said.
TransUnion last year found 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 an advance estimate were provided.
Hospital price transparency rules now in effect could make finding that information easier, but facilities have so far been mostly noncompliant. Last week, CMS said it was hiking up the fees for hospitals that don't post their chargemasters online to as much as $2 million a year for larger facilities.