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How health insurance literacy can affect the financial hardship of cancer

Few adults have the knowledge and ability to obtain health insurance information that can impact their ability to best use their benefits.

Jeff Lagasse, Associate Editor

Does health insurance literacy have a correlation to medical financial hardship, particularly as it pertains to cancer? A new report finds the answer to that question is yes.

The latest American Cancer Society study links health insurance literacy with medical financial hardship as well as non-medical financial sacrifices among adult cancer survivors in the U.S. The authors say the study indicates that health insurance literacy may be an important intervention for addressing financial problems associated with cancer. The report appears in JNCI Cancer Spectrum.

Rising costs of cancer care can result in financial hardship for cancer survivors, even among those with health insurance. Meanwhile, growing evidence indicates that many adults have limited knowledge, ability and confidence to obtain, evaluate and use health insurance information that may impact the ability to best use health benefits. This can lead to unnecessary medical spending.

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Improving health insurance literacy has been proposed as a potential intervention to help minimize financial hardship. To date, however, little has been known about the associations between health insurance literacy and medical financial hardship and non-medical financial sacrifices in cancer survivors.

To learn more, ACS investigators identified 914 adult cancer survivors from the 2016 Medical Expenditure Panel Survey Experiences with Cancer self-administered questionnaire, a nationally representative household survey overseen by the Agency for Healthcare Research and Quality. The survey addresses financial hardship, health insurance coverage and access to care related to cancer, its treatment and the lasting effects of treatment.

Health insurance literacy was measured by the question "Did you ever have a problem understanding health insurance or medical bills related to your cancer, its treatment, or the lasting effects of that treatment?" Medical financial hardship was measured by reports of problems paying medical bills, worry about paying medical bills, and delaying or foregoing care because of cost. Non-medical financial sacrifices were measured by changes in spending, living situation, or use of savings.

They found that adult cancer survivors aged 18-64 with health insurance literacy problems were more likely to report any material hardship, and more likely to report psychological hardship, than those without the literacy problems. Cancer survivors with health insurance literacy problems were also more likely to report all types of non-medical financial sacrifices, and more likely to report any financial sacrifices than those without the problems.

Potential interventions that could address the issue include financial and health insurance navigation, decision aids and easier-to-read medical bills, which improve patients' understanding of their insurance and medical costs.


Insurance literacy isn't the only issue consumers face. Half of U.S. consumers are unable to navigate the complexity of the healthcare system on their own, according to a 2018 Accenture report, and this low level of health system literacy costs the industry an estimated $4.8 billion annually in administrative expenses alone.

Overall, just one in six consumers, about 16 percent, are considered to be experts in navigating the system. One-third have no experience or proficiency with it whatsoever.

Twitter: @JELagasse

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