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Cost, Not COVID-19, is the Top Reason Patients Defer Care

Analysis  |  By Alexandra Wilson Pecci  
   June 02, 2021

Even so, a new survey found that 64% of providers cited getting patients back in after COVID-19 as their top priority.

Although much has been made in the past year about patients skipping care because of COVID-19, a new survey shows that there's an even bigger reason that people skip recommended healthcare: Cost.

Even though cost is the No. 1 factor for skipping care, healthcare providers are more focused on getting patients back in the door after the pandemic than they are about affordability.

That's according to the Patientco 2021 State of the Patient Financial Experience Report, which surveyed more than 3,000 patients and nearly 50 healthcare providers across the United States.

It found that 64% of providers cited getting patients back in after COVID-19 as their top priority, followed by solving for price transparency, which 51% of providers cited. Reducing costs; addressing talent and resource constraints; and the No Surprises Act tied for third.

However, nearly one-third of patients say they've avoided care because they were worried about what they would owe. In fact, 45% of patients would need financial assistance for bills that exceed $500; 66% would need it for bills that exceed $1,000.

In fact, cost is a concern for all patients, regardless of income level.

For instance, 85% of patients with household incomes greater than $175,000 are less likely to defer care when flexible payment options are available.

Another area where patients need help is in deciphering their medical bills. More than half of patients say their medical bills are confusing, and most patients have struggled to understand their medical bills and what they owed; these findings are consistent across income levels, age groups, and education.

For example, the survey showed that 52% of people with a PhD of higher struggled to understand what was covered by insurance on their last medical bill.

Additional survey findings include:

  • 34% of patients said they have never received a pre-visit cost estimate.
  • Only 18% of providers use a patient's medical bill balance to assess eligibility for financial assistance; instead, 72% use the patient's income level.
  • 72% of patients think their healthcare provider should consider affordability in making treatment recommendations.
  • 80% of patients would be less likely to defer care when affordable payment options are available.
  • 26% of patients didn't get financial assistance to help pay a medical bill they couldn't afford.
  • The No. 1 reason patients are loyal to their provider is because they're in-network (60%), far ahead of quality of care (38%) and location (38%).
  • However, when providers were asked about how they drive patient loyalty, their in-network status wasn't a factor at all. Instead, 97% of providers cited quality care.
  • Healthcare bills (tied with outstanding debt like credit cards and student loan payments) were the top expense that patients would defer in hard times.

Alexandra Wilson Pecci is an editor for HealthLeaders.

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