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Providers must be flexible, get creative in helping patients afford their healthcare, TransUnion study shows

TransUnion's Jonathan Wiik weighed in on study released at HIMSS18 that shows Americans can't afford their healthcare now, and it will get worse.

Beth Jones Sanborn, Managing Editor

LAS VEGAS -- A new TransUnion Healthcare analysis released at the HIMSS18 global conference in Las Vegas revealed that patients continue to grapple with rising healthcare costs, and there is no end in sight. The study revealed that patients experienced an 11 percent increase in average out-of-pocket costs during 2017, increasing from $1,630 in Q4 2016 to $1,813 in Q4 2017. 

The TransUnion Healthcare analysis used anonymous data estimates from numerous providers including hospitals and healthcare clinics nationwide. The data focused on patient payment responsibilities for key, commonly administered procedures.

It also showed that in 2017 at least 39 percent of patients saw per visit out-of-pocket costs over $500. An average of 49 percent of patient out-of-pocket costs per healthcare visit were below $500, but 39 percent were $501 to $1,000 and 12 percent were more than $1,000.

Meanwhile, the economic strife patients grapple with is also worsening, creating a double whammy for the healthcare industry and patients. The study cited a 2016 Federal Reserve Economic Report of household income that showed 35 percent of adults would be unable to make all of their other bill payments in full if faced with a $400 emergency. So for the 51 percent of patients who saw per visit out-of-pocket costs greater than $500, their household finances were likely thrown into chaos as a result of the healthcare costs they incurred, and even for the 49 percent who saw costs under $500, financial complications likely arose as a result of the care they received.

"I think there's something called benefits literacy that's sort of this plague that people don't know about. I think people shop their health insurance like they shop for rent or airline tickets. They don't look at the fine print. They also gamble. They think they are healthy and nothing is going to happen, and then a heart attack, car wreck, kid breaks their arm or cancer surprises them," Wiik said. 

TransUnion Healthcare's analysis also painted a grim picture for those facing major procedures.. Medical specialties with the highest out-of-pocket cost estimates for patients, included: Orthopedics with $1,663 average out-of-pocket costs, plastic surgery with $1,566, urology with $1,415 and neurology with $1,241. All of these categories topped out above the $1,000 average across all specialties in the fourth quarter.

"There is not liquidity in the average U.S. household to handle that and it's going to continue to rise. We know healthcare costs are going to continue to go up with no end in sight. All the legislation we are seeing is showing access or coverage but none of it is addressing cost. The accountable care, bundles are sputtering at best to counter cost. If you can't curb the cost, you're going to have to curb the payment. And do that, providers are going to have to get creative," Wiik said.

With millions of dollars of unpaid medical bills, many hospitals are instituting processes to protect their revenue. Wiik said providers must take a more upfront, consultative approach when dealing with patients who are facing high bills. He said it is going to take tools and patience, and hospitals may see themselves operating more like banks.

"Providers are financing five to seven years loans. Those are cars. They are setting up the same kind of loans for your healthcare that they do for cars. That alarms me. People want cars, they don't want to have to finance their healthcare. But they are going to have to."

Twitter: @BethJSanborn
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