Health Insurance Trends Driving Medical Debt

The Buzz

Medical debt is a persistent problem for hospitals that are doing their best to provide quality care to the communities they serve. Financial assistance programs are offered by hospitals to help those that need it the most. However with the state of today’s health insurance trends, they will never be able to replace quality health insurance plans that cover preventative and necessary care at an affordable price.

Two of the main drivers when it comes to an increase in medical debt are uninsured patients and high-deductible health plans. Both of these situations in health insurance trends open patients to financial vulnerability. Often patients must decide if seeking treatment is worth the debt, which can cause medical issues to become worse, causing more debt in the long term.

What’s Behind Medical Debt?

Before we can begin to work towards relieving medical debt, we need to understand what’s really causing patients to face healthcare expenses that are beyond their ability to pay.

A common health insurance trend is that a large number of Americans remain uninsured. With the introduction of the Affordable Care Act (ACA) in 2010, many people were able to get coverage that were unable to before. But in 2021 27.5 million people still did not have coverage. The Coronavirus pandemic did increase the number of Medicaid recipients, but according to a Kaiser Family Foundation report, between 8 million and 24 million people will lose Medicaid coverage during the unwinding of the continuous enrollment provision.

This health insurance trend of Medicaid coverage loss could have a staggering impact on how many patients will have no health insurance in the near future. It will leave them with healthcare bills they are unable to afford.

Another health insurance trend is that high-deductible health plans are too high. Many employers now offer high deductible health plans (HDHP’s) to their employees as a way to keep costs low for both parties. While these types of plans do cover preventive care and offer comprehensive benefits with standard consumer protections, they increase patient’s financial exposure, leaving them open to medical debt if they seek care.

In 2022 the IRS defined high deductible health plans as any plan with a deductible of at least $1,400 for an individual or $2,800 for a family. An HDHP’s total yearly out-of-pocket expenses (including deductibles, copayments, and coinsurance) can’t be more than $7,050 for an individual or $14,100 for a family. This means that a patient has to pay AT LEAST $1,400 BEFORE their benefits kick in.

The Federal Reserve did an Economic Well-Being of U.S. Households Survey in 2022 and found that 37% of Americans did not have enough in savings to cover a $400 emergency expense, up 5% from 2021. So even those that do have health insurance are unprepared for an emergency.

Making a Positive Impact

Hospitals and health systems are some of the strongest proponents of comprehensive coverage. Every day you work to find ways to make coverage more affordable and accessible for all your patients, regardless of their ability to pay. But in 2020 alone, hospitals and health systems provided more than $42 billion in uncompensated care. This number is amazing, but also unsustainable.

The root causes of medical debt primarily stem from inadequate healthcare coverage. The current landscape of health insurance trends need to change. Health plans should ensure the coverage they offer does not result in unaffordable bills and medical debt. This battle is being fought by many groups including the American Hospital Association (AHA), and other healthcare groups. While they are trying to make change overall, there are things you can do now.

• Review the AHA voluntary patient billing guidelines. These guidelines address issues such as assisting patients who cannot pay and protecting patients from certain debt collection practices.
• Work with change. Nothing in our world is static, and that includes your patients’ financial situations. Asking questions early can allow you to see if charity care of Medicaid have become viable options.
• Make your voice heard. There’s power in numbers, so work with your state and national organizations to speak out. Contact your representatives and senators to let them know that this is a serious problem that could lead to reduced care.
• Use an early out partner. If you can reach your patients before sending them to collections, you may be able to create a plan to satisfy both parties. Companies like Americollect, that are 100% healthcare focused, understand the nuances of medical payments. They work with both you and your patients for positive outcomes and ultimately recovering your revenue.

Conclusion

Medical debt is a problem that needs a solution to ensure you are able to deliver the best care possible. Uninsured patients and high deductible health plans make it harder to give your patients the care they deserve. Even though this problem is not going to be solved overnight, you can take steps to move existing health insurance trends in the right direction. Americollect is here to help you navigate uncompensated care and find ways to make you and your patients as happy as possible.