21 statistics on high-deductible health plans

Hospital and health system executives are well aware of the affects high-deductible health plans have had on hospital finances, from patient collections to bad debt. To help quantify the impact of increasing patient financial obligations on the business of healthcare, here are 21 statistics to know about high-deductible health plans.


1. The Affordable Care Act has lowered the uninsured rate in the U.S., but it has not relieved the financial pressure hospitals experience from providing uncompensated care. The uninsured rate in the U.S. has fallen from 15.7 percent in 2009 to 9.1 percent in 2015, according to a report from the CDC.


2. Hospitals and health systems used to collect a majority of healthcare reimbursements from government or commercial payers. With the rise in popularity of high-deductible plans, hospitals are interfacing more than ever with patients to collect on accounts.  From 2011 to 2014, the number of consumer payments to healthcare providers increased 193 percent, according to a study from InstaMed.  


3. Patients with high-deductible policies are grappling with significantly greater out-of-pocket costs. Kaiser Family Foundation reports the average annual out-of-pocket costs per patient rose almost 230 percent between 2006 and 2015.


4. The same Kaiser Family Foundation study found employee deductibles on average increased 67 percent from 2010 to 2015.


5. Rising insurance deductibles have outpaced the average increase in employees' wages during the past five years, according to Kaiser Family Foundation. Workers' wages increased 1.9 percent between April 2014 and April 2015, whereas American's out-of-pocket medical expenses jumped 9 percent from 2014-2015.


6. Hospitals take on bad debt when patients fail to satisfy their financial obligations. Since 2000, U.S. hospitals have provided more than $502 billion in uncompensated care expenses, according to a report from the American Hospital Association.


7. Many hospitals have attributed a jump in bad debt expenses to patients' increasingly unaffordable insurance deductibles. For insured patients, management consulting firm McKinsey & Company estimated the rate of bad debt is increasing at well over 30 percent each year in some hospitals.


8. Twenty-four percent of employees enrolled in employer-sponsored high-deductible plans in 2015, up from just 4 percent of employees in 2006, according to Kaiser Family Foundation.


9. About 52 percent of employers offered a minimum of one high-deductible health insurance plan to employees in 2015, according to a report by Benefitfocus.


10. Given the choice of a high-deductible option, about 41 percent of employees chose HDHPs, according to Benefitfocus.  


11. Millennials are the most likely demographic to choose high deductible plans. Benefitfocus' study found 44 percent of millennials chose low cost plans with high deductibles when given the option.


12. As deductibles continue to creep upwards at a faster rate than workers' wages, and as the number of patients enrolled in high-deductible plans increases, a greater number of insured patients have reported difficulty paying medical bills. Among Americans aged 65 or under who have insurance, 20 percent said they had problems paying medical bills within the past year.


13. According to Kaiser Family Foundation, 43 percent of insured patients said they delayed or skipped physician-recommended tests or treatment because of high associated costs.

14. Patients' ability to afford medical services decreases significantly depending on how their deductible stacks up to their household income. For patients whose deductibles equaled 5 percent or more of their annual income, 40 percent said they chose not to see a physician, get a medical test or visit a specialist, according to a survey by Commonwealth Fund.

15. When patients delay necessary or preventive medical care, they may end up in hospitals' emergency rooms for treatment. About 80 percent of emergency physicians said they are treating insured patients who have sacrificed or delayed medical care due to unaffordable out-of-pocket costs, co-insurance or high deductibles, according a poll by the AmericanCollege of Emergency Physicians. ACEP said this is a 10 percent increase compared to six months ago, when emergency physicians were asked the same question.


16. A KFF survey of employers found employee deductibles increased 67 percent from 2010 to 2015.


17. In the individual ACA marketplaces, almost 90 percent of enrollees are in a plan with a deductible beyond the qualifying threshold for an HDHP, reports Health Affairs. The threshold is $1,300 for individuals and $2,600 for families in 2015.


18. For employer-sponsored health plans, the average deductible for individual coverage was $2,196 for health savings account-qualified HDHPs in 2015.


19. By offering high-deductible plans, employers are better able to control healthcare spending by shifting financial responsibilities onto employees. A study from the National Bureau of Economic Research indicated employers that offered high deductible plans reduced company healthcare costs over three years.

20. Impending policy set to take effect in 2018 could drive more employers to offer high deductible plans. The ACA's so-called Cadillac Tax is an excise tax of 40 percent on employer-sponsored plans valued at more than $10,2000 for individuals and $27,500 for families. Research indicates employers may continue to shift healthcare expenses onto employers as one way to keep plans below taxation levels.

21. As healthcare spending continues to climb, some expect the prevalence of high-deductible plans to increase. According to Health Affairs, healthcare spending is predicted to outpace GDP growth through 2024. Healthcare spending is growing at a rate of 5.8 percent from 2014 to 2024, and is expected to amount to 19.6 percent of the GDP by 2024.


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