Out-of-Pocket Spending was Mostly Concentrated in Short Time Intervals

More than 80% of enrollees were responsible for a portion of their healthcare costs, with an average annual cost sharing of $954.

Out-of-pocket spending by healthcare consumers was mostly concentrated in short time intervals, according to a Health Affairs study released Monday afternoon.

The study, based on data from a large database of commercial payer claims from 2017, found that almost one-third of people with "above-the-median total annual health care spending" incurred half of their annual out-of-pocket spending in a single day.

Based on the analysis, researchers found that 11% of commercial insurance enrollees did not have a healthcare interaction in 2017 and only 6% had at least one encounter with no cost sharing.

However, 83% of enrollees were responsible for a portion of their healthcare costs, with an average annual cost sharing of $954.

The study's researchers concluded that individuals with employer-sponsored health insurance still incur "substantial" out-of-pocket spending in a short period, leading to downstream issues for the industry.

"Policy makers working to improve the affordability of care should focus not only on curbing the growth of health care prices but also on innovative approaches to cost sharing that prevent dramatic financial shocks to household budgets as a result of medical bills," the authors wrote.

The study included several data points relating to when consumers incurred out-of-pocket spending and how much in each instance.

Almost two-fifths of commercially insured consumers incurred half of their annual out-of-pocket spending in a single encounter, while just over a quarter of consumers incurred 90% of annual spending in one or two encounters.

One-third of consumers with "low demand for health services" incurred no cost sharing during the year and over 40% reached half of their annual out-of-pocket spending in a single day.

Notably, while only 0.4% of people reached the "in-network out-of-pocket maximum" for individuals enrolled through the Affordable Care Act, 14% of those consumers reached that amount in a single day.

Jack O'Brien is the Content Team Lead and Finance Editor at HealthLeaders, an HCPro brand.