A patient survey shows that patients want upfront healthcare cost estimates. Meanwhile, mental health practitioners argue that the new way they're required to issue estimates won't work for their industry.
An overwhelming majority of patients surveyed—89%—say knowing the amount of their healthcare bill and making a payment before their visit would have been an easy way to pay for their most recent medical visit.
Yet, 70% of consumers either didn't receive a cost estimate before their most recent healthcare visit or were unsure about whether they received one.
Those are findings of a survey by PYMNTS, which polled 3,546 adult American consumers about their healthcare payment experiences.
In addition, cost and insurance coverage are key reasons patients didn't seek needed medical care.
The survey found that 33% of consumers have opted out of seeking needed medical care, either by not making necessary healthcare appointments or abandoning needed treatment.
Of those patients, 21% say that cost was the top reason for not getting the care. Another 11% said that they didn't seek or continue care because their health insurance plan would not cover the appointment or treatment.
Insurance coverage also affects where people seek their medical care. The PYMNTS data finds that most patients would switch their current providers if their insurance stopped covering their visits. In addition, 59% said services not being covered was an important reason why they would consider leaving their healthcare provider.
Blanket rules about providing upfront estimates might not work, though.
That's the argument that 11 industry groups representing mental health providers, including the American Psychological Association, the National Association of Social Workers, and the American Psychiatric Association, made in a letter to Health and Human Services.
They say that although their industry already prioritizes sharing cost information with patients, providing the specific kind of "good faith estimates" required under the No Surprises Act places an undue burden on mental health practitioners.
They note, among other things that:
- Requiring clinicians to fill out and update the good faith estimate (GFE) form "every time there is a minor change in the treatment plan that may or may not have an impact on costs takes away from valuable treatment time."
- The rule "fails to capture the practical nuances involved in referring patients to other independent mental health practitioners for treatment, as well as the urgency under which appointments are scheduled."
- Insurers may use the good faith estimates "as a mechanism or justification to limit mental health treatment beyond the scope of the GFE, or otherwise view them as an admission that the patient will only require a certain degree of mental health treatment."
Alexandra Wilson Pecci is an editor for HealthLeaders.
