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Nearly Half of Patients Still Don't Understand Their Medical Bill

Analysis  |  By Alexandra Wilson Pecci  
   October 21, 2020

The COVID-19 pandemic is helping to further drive healthcare consumerism, finds TransUnion Healthcare's second annual patient survey.

Despite the looming price transparency rule deadline, nearly half of consumers still didn't understand their financial responsibility for a recent medical bill.

That's one of the findings from TransUnion Healthcare's second annual patient survey, which polled more than 3,000 people in September 2020 who had either visited a hospital, healthcare clinic, doctor's office, or other healthcare organization for treatment during the past 12 months.

It showed that only 52% of patients fully understood their financial responsibility for their recent medical bill.

"Transparency is here to stay. The survey's finding that only 52% of respondents understood their bill surrounds issues in health literacy and patient engagement," Jonathan Wiik, principal of healthcare strategy at TransUnion Healthcare, tells HealthLeaders via email. "Healthcare has had a guarded pricing and payment system since its inception. As consumers shoulder more of the burden of healthcare costs, providers will need to have an innovative patient financial experience and engagement strategy that meets patient as payer."

Indeed, the survey shows that understanding costs is key to a good financial experience and a patient's propensity to pay: 60% of the patients surveyed said are at least somewhat likely to pay their bill upfront if a cost estimate is offered in advance or at the time of service.

When given an estimate at the time of service, 65% of patients said they would make at least a partial payment.

However, just 53% of recent patients received clear cost estimates prior to receiving treatment, a three-basis point year-over-year increase.

In addition, consumers want and actively seek out clear cost information, with 80% of respondents using sources like healthcare provider or insurance websites to research healthcare costs, up from 75% in 2019.

Younger generations are more likely to be researching costs compared to older generations (90% of Gen Zers, and 87% of Millennials, versus 69% of Baby Boomers).

In addition, 47% of recent patients chose their healthcare provider based on cost.

"Providing self-service estimates, financial assistance, and flexible payment options for patients enables a frictionless payment experience, and helps patients focus on getting better versus worrying about their bill," Wiik says.

The survey also asked about other healthcare cost views, behaviors, and insurance status and found that:

  • 59% of patients deferred non-COVID-19 related medical care during the past six months
  • 49% indicated that the state of the economy has at least some impact on how they seek medical care, a seven basis-point increase from 2019
  • 33% of Gen Zers and 29% of Millennial patients reported their health insurance coverage was impacted due to the pandemic, compared to 22% of overall respondents; 18% of Gen X; and 12% of Baby Boomers
  • The overall change in out-of-pocket costs is limited when compared to 2019 levels (inpatient is down 5% year-over-year to $5,002; outpatient is up 6% year-over-year to $1,095; and emergency department is down 7% year-over-year to $485)

Alexandra Wilson Pecci is an editor for HealthLeaders.

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