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Analysis

Financial Problems Aren't the Only Reason that Patients Don't Pay Their Medical Bills on Time

By Alexandra Wilson Pecci  
   November 19, 2020

The bills themselves stood in the way of people paying, with only 43% of respondents to a new survey saying they fully understood their most recent medical bill.

Patients crave healthcare cost information and are more stressed about their medical bills than their actual medical procedures, yet 65% of them are unaware of the upcoming CMS price transparency rule, finds a new survey.

Waystar surveyed 1,000 consumers who have received a medical bill from a hospital or specialty provider for medical treatment within the last six months and found that 56% have received a surprise medical bill.

In addition, 48% have been late on a medical bill payment, money issues aren't the only reason why.

  • 51% couldn't pay because of financial problems
     
  • 37% assumed their insurance would pay for it
     
  • 19% were unclear about how much money they owed
     
  • 18% said it was because the bill was incorrect
     
  • 16% just forgot
     
  • 13% weren't sure when the payment was due

As illustrated by this data, the bills themselves stood in the way of people paying. In fact, only 43% of those surveyed said they fully understood their most recent medical bill. That number was even lower among Gen Z/Millennial patients (37%).

Related: Millennials Have More Surprise Bills, Less Savings

When asked what they needed to understand their bills more, respondents said:

  • An upfront explanation from their provider about what their insurance will cover (46%)
     
  • A simpler bill that only includes essential information (40%)
     
  • A more clearly written explanation of benefits (37%)
     
  • Access to online resources to walk patients through their bill (33%)
     
  • Having a medical professional explain it to me (27%)

The survey also asked respondents what would make it easier for them to pay their bills on time, and wanting more clarity and assistance were prominent responses:

  • Financial assistance because they can't afford to pay on time (51%)
     
  • A clearer explanation of what is owed versus what insurance will cover (42%)
     
  • Payment plan options (38%)
     
  • A clearer explanation of when payments are due (24%)

Consumers also revealed that they do seek out cost information: 67% have asked about price before going to the doctor or hospital, and younger consumers do it more often, with 83% of Gen Z/Millennials doing so, compared to 63% of Gen X and 50% of Boomers.

Related: Consumers Want Price Transparency Info They Don't Know They Have Access To

Although 46% of consumers say that their provider proactively gave them an upfront cost estimate for healthcare services, those estimates weren't always accurate.

Only 38% said their estimate was completely accurate compared to the final bill they received, and 54% said it was only somewhat correct or not correct at all.

The survey also drives home the point that personalized estimates make a real difference for patients, with 81% of them saying that know their actual out-of-pocket costs (rather than the standard price, which will be required by the new CMS mandate) would prompt them to more actively pursue care.

Alexandra Wilson Pecci is an editor for HealthLeaders.


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