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Half of Patients with High-Deductible Health Plans Have Received an Unexpected Bill

Analysis  |  By Jay Asser  
   January 20, 2023

Findings from a survey reveal shared negative experiences with surprise billing, billing estimates, and medical debt.

As more and more people continue to choose high-deductible health plans (HDHPs), the patient financial experience is likely to include issues related to medical billing, according to a YouGov survey commissioned by revenue cycle firm AKASA.

The survey fielded responses from 2,206 individuals, including 179 with employer-sponsored HDHPs, between March 9 and March 14, 2022.

When asked if they had ever received a surprise medical bill, 50% of the individuals with employer-sponsored HDHPs said they had.

Respondents were also asked if they had ever received a bill that did not match the upfront price estimate for care or services. More than half (53%) with employer-sponsored HDHPs answered yes.

Negative experiences among the respondents during the billing process didn't just end at receiving the bill but extended into medical debt.

More than a third (34%) of those with HDHPs said they had been harassed by a medical debt collector before, while 44% of individuals with HDHPs stated they had experienced financial hardship from bills.

"Enrollment in high deductible health plans grew 43% from 2014 to 2019, and with it has come a similar rise in patient responsibility for payments," said Amy Raymond, VP of revenue cycle operations at AKASA.

"With high health insurance premiums, deductibles, and cost of care, patients are shouldering more of the financial burden of healthcare. This has led to increasing rates of bad debt for hospitals and health systems. Providers must modernize their systems with options that drive more consistent patient behaviors in paying for services."

Another survey commissioned by AKASA found that medical bills are more likely to come across as confusing than straightforward to patients.

In that survey, more respondents either found bills extremely confusing (19%) or somewhat confusing (19%), compared to those that said bills are not confusing (11%) or leaned towards bills not being confusing (14%).

Jay Asser is an associate editor for HealthLeaders.


KEY TAKEAWAYS

A YouGov survey commissioned by revenue cycle firm AKASA fielded responses from 2,206 Americans, including 179 with employer-sponsored high-deductible health plans.

Half of the respondents said they've received a surprise medical bill, with 53% saying they had a received a bill that did not match the upfront price estimate.

More than a third (34%) of those with HDHPs stated they've been harassed by a medical debt collector, while 44% said they had experienced financial hardship from bills.


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