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High-Deductible Health Plans Cause Patients to Delay Care

Analysis  |  By Alexandra Wilson Pecci  
   June 16, 2020

High-cost insurance deductibles also cause physicians to change the way they provide care, finds a survey of independent physicians.

High-cost insurance deductibles are preventing patients from getting the healthcare they need, as well as changing the way physicians provide care, finds a survey of more than 700 independent physicians.

Eighty percent of respondents say that their patients refuse or delay medical care due to concerns about cost, found the survey administered by NORC at the University of Chicago for the Physicians Advocacy Institute (PAI).

Seventy-nine percent say that high insurance deductibles are a leading cause of those cost concerns.

High-deductible health plans aren't only impacting patients' treatment decisions, though; they're also affecting the way physicians do their jobs.

For instance, the survey found that:

  • 55% of physicians surveyed said patient cost concerns are causing them to change how they prefer to time treatments
  • 66% have changed their decision about whether to prescribe drugs
  • 61% changed the type of medical treatment provided
  • 86% have changed which types of drugs they prescribe

In addition, physicians say that high-deductible health plans are challenging for their daily workflow and tasks.

For instance, most say their office staff spends more than 300 hours per year educating patients about their insurance coverage. However, 75% say they don't have most of the information they need to have cost of care conversations.

Instead, just 15% of physicians say they're very prepared for cost-of-care discussions with patients, and only 40% said their offices offer tools to help patients understand costs on their own.

Finally, high-deductible health plans appear to have a negative impact on physicians' financial health.

NORC researchers report that 51% of physicians say office capacity issues arise when patients delay necessary medical treatments due to cost. In addition, 74% of independent doctors say it takes more than a month to receive payment from insurers for services rendered.

"High-deductible health plans were supposed to make us better healthcare consumers, but they have failed," Donald J. Palmisano, Jr., executive director and chief executive officer of the Medical Association of Georgia and a member of PAI's board of directors, in a statement. "They force people attracted by low premiums to choose between healthcare and housing, or food. They're an idea that turned out to be bad for both patients and doctors."

Alexandra Wilson Pecci is an editor for HealthLeaders.

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