Engaging transparency tools can help lower medical costs

Health plans have been deploying transparency tools, but they are often underutilized, not intuitive or don’t provide the whole picture.

Having health insurance doesn’t alleviate anxiety around medical costs, according to a new survey. Part of the Vitals Index, the survey comes on the heels of the extended deadline for consumers to sign up for health insurance under the Affordable Care Act, and more than 1,200 people were polled about the affordability of medical care.

Thirty percent of people responded that they have personally experienced medical debt and financial hardship due to medical bills, and about 42% of insured people said they still worry somewhat or a lot about paying for medical or pharmacy bills. Additionally, thirty percent of respondents who had debt also carried insurance.

“Out-of-control costs are not only a problem for consumers, but also for health plans,” says Mitch Rothschild, CEO of Vitals. “However, consumers are often unaware of these cost differences. Unlike other services and products, the cost of medical care is only apparent after the fact. Health plans have been deploying transparency tools, but they are often underutilized, not intuitive or don’t provide the whole picture.

“Part of the issue is that many plans are providing cost information, but are not offering quality data,” Rothschild continues. “And in the absence of quality information, cost becomes a proxy for quality. Patients might assume, as they do in shopping for cars or houses, that the more expensive hospital will provide superior care.”

True transparency not only allows consumers to make informed decisions, but to also make tradeoffs, according to Rothschild. “For example, a new parent could choose to pay more because a pediatrician offers extended office hours or an older adult could choose their primary care doctor because of a more convenient location.

“When more care facilities and health plans begin deploying engaging transparency tools, they will bring real benefits,” he adds. “In addition to rewarding providers who deliver higher-quality care at lower prices with more patients, they will also help health plans manage overall member costs, improve outcomes and achieve competitive advantages.”


Other survey findings

The financial burden of medical care was felt more in affluent households, according to the survey:

  • Households with higher income were more prone to experiencing medical debt: The highest incidence of hardship (34%) occurred in households with incomes between $50,000 to $99,999-a threshold above the American average income for families. Twenty-two percent of those who experienced debt or financial hardship had household incomes above $150,000.

  • Households with incomes less than $25,000 had the lowest incidence of medical debt and financial hardship (10%)

Women were more likely to feel the pinch of healthcare costs compared to men (61% vs. 39%).

Education levels didn’t preclude people from experiencing financial pain. Nearly 22% of those with a graduate degree had financial hardship from healthcare costs, while only 8% only high school diplomas reported the same.

“The rise of high-deductible plans, coupled with a lack of transparency around healthcare costs and quality has delivered a devastating effect on individuals and families,” Rothschild says. “In fact, more than 60% of bankruptcies in America are due to medical debt. On the road to financial ruin, many families deplete their savings, lose long-term assets and delay the care they need to avoid more medical bills. Consumers need access to tools and information to provide increased transparency in order to enable families to make better, more informed medical choices.”

Vitals found that 60% of survey respondents have no additional savings or structured account set up for medical bills.